administrative office of the courts state of new jersey

Transcripción

administrative office of the courts state of new jersey
ADMINISTRATIVE OFFICE OF THE COURTS
STATE OF NEW JERSEY
GLENN A. GRANT, J.A.D.
ACTING ADMINISTRATIVE
DIRECTOR OF THE COURTS
RICHARD J. HUGHES
JUSTICE COMPLEX
PO BOX 037
TRENTON, NEW JERSEY 08625-0037
[Questions or comments may be
directed to 609-292-4638.]
Directive # 14-08
(Supersedes Directives
#4-02, #12-03 and #13-05)
TO:
ASSIGNMENT JUDGES
CRIMINAL PRESIDING JUDGES
FROM:
GLENN A. GRANT, J.A.D.
SUBJ:
CRIMINAL PLEA FORMS AND JUDGMENT OF CONVICTION
DATE:
OCTOBER 8, 2008
This Directive (1) reissues all of the previously promulgated criminal plea forms,
and (2) promulgates amendments to certain of those plea forms and to the Judgment of
Conviction as recommended by the Supreme Court Criminal Practice Committee.
The Certification Application for Appointment of a Private Prosecutor (Attachment
3 of Directive #13-05) is being reissued under a separate directive (Directive #13-08).
Thus, those three prior directives – Directives #4-02, #12-03, and #13-05 – are now
superseded in their entirety. However, to the extent that those prior Directives
contained explanatory information, judges may still find them instructive.
The amendments are promulgated pursuant to the authority of Rule 3:9-2, which
provides that plea forms are to be in a form “prescribed by the Administrative Director of
the Courts.” In addition, the Supreme Court, at its March 1, 1999 Administrative
Conference similarly delegated to the Administrative Director the authority and
responsibility to approve the form of the Judgment of Conviction.
Each form also will be posted separately on the forms page of the Judiciary
Internet website at http://www.judiciary.state.nj.us/forms.htm.
You should begin using these forms as soon as possible. English and EnglishSpanish versions of all forms promulgated by this Directive are attached.
Directive #14-08
October 8, 2008
Page 2
Any questions or comments regarding this Directive, or the appended forms,
should be directed to Assistant Director Joseph J. Barraco, Esq. at (609) 292-4638.
PLEA FORMS
1.
Four-Page Plea Form
(Supersedes Attachment 1 of Directive #13-05 and
Supplement to Directive #13-05)
Attachment 1
The four-page Plea Form has been amended as follows:
1)
to add questions #4d and 4e addressing the defendant’s
understanding that he/she is waiving review of the denial of any
pretrial motions, except those specifically reserved for appellate
review, and adding language designed to set forth those matters
that are preserved for appeal, pursuant to the court rules,
notwithstanding a guilty plea.
2)
to add question #7b to address sentencing exposure if a defendant
is pleading guilty to a charge that requires a mandatory extended
term.
3)
to amend question #17 addressing immigration to add paragraphs
a and b to inquire into whether the defendant is a United States
citizen. If the defendant answers “No”, to advise the defendant of
the consequence that by virtue of the guilty plea, the defendant
could be deported.
4)
to add new questions #18a and 18b to advise the defendant of the
possible restrictions pursuant to the Interstate Compact for Adult
Offender Supervision.
The remaining questions on the form have been renumbered.
2.
Supplemental Plea Form for Non-Negotiated
Pleas
(Supersedes Attachment 2 of Directive #4-02)
Attachment 2
There are no changes to this plea form.
3.
Supplemental Plea Form for Sexual Offenses
(Supersedes Attachment 3 of Directive #4-02)
There are no changes to this plea form.
Attachment 3
Directive #14-08
October 8, 2008
Page 3
4.
Additional Questions for Certain Sexual
Offenses Committed on or after December 1,
1998
(Supersedes Attachment 2 of Directive #12-03)
Attachment 4
There are no changes to this plea form.
5.
Additional Questions for Certain Sexual
Offenses (Megan’s Law Plea Form)
(Supersedes Attachment 2 of Directive #13-05)
Attachment 5
The Additional Questions for Certain Sexual Offenses (Megan’s Law Plea
Form) has been amended as follows:
1) Effective March 1, 2007, L. 2007, c. 19, amended Megan’s Law,
N.J.S.A. 2C:7-2, to upgrade the penalty for failure to register as a sex
offender from a fourth degree crime to a third degree crime. The law also
imposes a penalty for failure to verify an address. It is a fourth degree
crime for a person to knowingly provide false information concerning his
place of residence or to fail to verify his address as required by Megan’s
Law.
Questions #1(c) and 2(b) on the Additional Questions for Certain Sexual
Offenses Plea Form have been amended accordingly.
2) Effective February 27, 2008, L. 2007, c. 219 limits internet access for
certain sex offenders who are subject to Megan’s Law registration,
community or parole supervision for life or who are under probation or
parole supervision. It further provides that any person who fails to comply
with internet access conditions is guilty of a fourth degree crime.
Questions #1(d) and 1(e) have been added to the form to address this
law.
3) Question #7 of the form has also been amended to reflect that an
individual could be subject to civil commitment for up to a life term.
6.
Supplemental Plea Form for Drug Offenses
(Supersedes Attachment 8 of Directive # 4-02)
Attachment 6
Effective January 12, 2006, L. 2005, c. 343, amended the Driver’s License
Suspension statute, N.J.S.A. 2C:35-16. The amendments authorize the
court to refrain from imposing a driver’s license suspension on a
defendant convicted of a drug offense upon a finding of compelling
Directive #14-08
October 8, 2008
Page 4
circumstances by the court.
Pursuant to the statute “compelling
circumstances” exist if the forfeiture of a person’s driver’s license “will
result in extreme hardship and alternative means of transportation are not
available.”
Question #2a of the Supplemental Plea Form for Drug Offenses has been
amended accordingly.
In addition, the questions on the plea form have been renumbered as
questions #1 and #2.
7.
Supplemental Plea Form for Theft of a Motor
Vehicle and Unlawful Taking of a Motor Vehicle
(Supersedes Attachment 7 of Directive #4-02)
Attachment 7
There are no changes to this plea form.
8.
Additional Questions for Certain Drug and
Weapons Offenses Committed on or after
June 24, 1998
(Supersedes Attachment 9 of Directive #4-02)
Attachment 8
There are no changes to this plea form.
9.
Supplemental Plea Form for No Early Release
Act Cases (for crimes occurring between
June 9, 1997 and June 29, 2001).
(Supersedes Attachment 10 of Directive #4-02)
Attachment 9
There are no changes to this plea form.
10.
Supplemental Plea Form for No Early Release
Act Cases (for crimes occurring on or after
June 29, 2001)
(Supersedes Attachment 11 of Directive #4-02)
Attachment 10
There are no changes to this plea form.
11.
Supplemental Plea Form for Graves Act Cases
(Supersedes Attachment 12 of Directive #4-02)
There are no changes to this plea form.
Attachment 11
Directive #14-08
October 8, 2008
Page 5
JUDGMENT OF CONVICTION
12.
Judgment of Conviction (JOC)
Attachment 12
(Supersedes Attachments 4 and 5 of Directive #12-03)
The Judgment of Conviction has been amended:
1) To clarify that lifetime community supervision for sex offenders is parole
supervision for life for offenses occurring on or after January 14, 2004.
Language has been added indicating that the court is sentencing the
defendant to parole supervision for life (PSL). In addition, language
limiting community supervision for life (CSL) for offenses occurring before
January 14, 2004 has been added to the JOC.
2) To include a penalty pursuant to N.J.S.A. 2C:14-10, which established
the Sex Crime Victim Treatment Fund and requires that a new penalty be
assessed against any person convicted of a sex offense as defined in
N.J.S.A. 2C:7-2.
3) To include a penalty pursuant to N.J.S.A. 2C:43-3.6, which requires that
an $800 Statewide Sexual Assault Nurse Examiner Penalty be assessed
for offenses that occurred on or after May 4, 2001 and are defined as a
“sex offense” in violation of N.J.S.A. 2C:7-2.
In addition, the three-page JOC used in cases involving theft of a motor
vehicle or unlawful taking of a motor vehicle and the two-page JOC used
in all other cases have been consolidated into one four-page reformatted
form. The new four-page Judgment of Conviction should be used for all
offenses.
Attachments
cc:
Chief Justice Stuart Rabner
Attorney General Anne Milgram
Public Defender Yvonne Smith Segars
County Prosecutors
Deborah Gramiccioni, DCJ Director
AOC Directors and Assistant Directors
Regional Deputy Public Defenders
Trial Court Administrators
Criminal Division Managers
Steven D. Bonville, Esq., Special
Assistant
Vance D. Hagins, Esq.
John Wieck
Melaney S. Payne, Esq.
ATTACHMENT 1
FOUR-PAGE PLEA FORM
ENGLISH AND ENGLISH-SPANISH VERSIONS
New Jersey Judiciary
County
Plea Form
Prosecutor File Number
Defendant’s Name:
before Judge:
List the charges to which you are pleading guilty:
Ind./Acc./Comp.#
Count
Nature of Offense
Degree
Statutory Maximum
Time
Fine
VCCA Assmt*
Max
Max
Max
Max
Max
Your total exposure as the result of this plea is: ................................Total
Please Circle
Appropriate Answer
2. a. Did you commit the offense(s) to which you are pleading guilty?
b. Do you understand that before the judge can find you guilty, you will have to tell the
judge what you did that makes you guilty of the particular offense(s)?
[Yes]
[Yes]
[No]
[No]
3. Do you understand what the charges mean?
[Yes]
[No]
[Yes]
[No]
[Yes]
[Yes]
[Yes]
[No]
[No]
[No]
[Yes]
[No]
[Yes]
[Yes]
[No]
[No]
[Yes]
[No]
4. Do you understand that by pleading guilty you are giving up certain rights? Among
them are:
a. The right to a jury trial in which the State must prove you guilty beyond a
reasonable doubt?
b. The right to remain silent?
c. The right to confront the witnesses against you?
d. Do you understand that by pleading you are not waiving your right to appeal (1) the
denial of a motion to suppress physical evidence (R. 3:5-7(d)) or (2) the denial of
acceptance into a pretrial intervention program (PTI) (R. 3:28(g))?
e. Do you further understand that by pleading guilty you are waiving your right to
appeal the denial of all other pretrial motions except the following:
5. Do you understand that if you plead guilty:
a. You will have a criminal record?
b. Unless the plea agreement provides otherwise, you could be sentenced to serve the
maximum time in confinement, to pay the maximum fine and to pay the maximum
Victims of Crime Compensation Agency Assessment?
c. You must pay a minimum Victims of Crime Compensation Agency assessment of
$50 ($100 minimum if you are convicted of a crime of violence) for each count to
which you plead guilty? (Penalty is $30 if offense occurred between January 9, 1986
and December 22, 1991 inclusive. $25 if offense occurred before January 1, 1986.)
*
Victims of Crime Compensation Agency Assessment
Defendant’s Initials_______________
Main Plea Form / Revised Form Promulgated by Directive #14-08 (10/08/2008), CN 10079-English
page 1 of 4
5. d. If the offense occurred on or after February 1, 1993 but was before March 13, 1995,
and you are being sentenced to probation or a State correctional facility, you must
pay a transaction fee of up to $1.00 for each occasion when a payment or installment
payment is made? If the offense occurred on or after March 13, 1995 and the
sentence is to probation, or the sentence otherwise requires payments of financial
obligations to the probation division, you must pay a transaction fee of up to $2.00
for each occasion when a payment or installment payment is made?
e. If the offense occurred on or after August 2, 1993 you must pay a $75 Safe
Neighborhood Services Fund assessment for each conviction?
f. If the offense occurred on or after January 5, 1994 and you are being sentenced to
probation, you must pay a fee of up to $25 per month for the term of probation?
g. If the crime occurred on or after January 9, 1997 you must pay a Law Enforcement
Officers Training and Equipment Fund penalty of $30?
h. You will be required to provide a DNA sample, which could be used by law
enforcement for the investigation of criminal activity, and pay for the cost of
testing?
[Yes]
[No]
[Yes]
[No]
[Yes]
[No]
[Yes]
[No]
[Yes]
[No]
6. Do you understand that the court could, in its discretion, impose a minimum time in
confinement to be served before you become eligible for parole, which period could be
as long as one half of the period of the custodial sentenced imposed?
[Yes]
[No]
7. Did you enter a plea of guilty to any charges that require a mandatory period of parole
ineligibility or a mandatory extended term?
a. If you are pleading guilty to such a charge, the minimum mandatory period of parole
ineligibility is
years and
months (fill in the number of years/months)
and the maximum period of parole ineligibility can be
years and
months (fill in the number of years/months) and this period cannot be reduced by
good time, work, or minimum custody credits.
b. If you are pleading guilty to such a charge, the minimum mandatory extended term
years and
months (fill in the number of years/months) and the
is
maximum mandatory extended term can be
years and
months (fill in
the number of years/months).
[Yes]
[No]
8. Are you pleading guilty to a crime that contains a presumption of imprisonment which
means that it is almost certain that you will go to state prison?
[Yes]
[No]
9. Are you presently on probation or parole?
a. Do you realize that a guilty plea may result in a violation of your
probation or parole?
[Yes]
[Yes]
[No]
[No]
[NA]
10. Are you presently serving a custodial sentence on another charge?
a. Do you understand that a guilty plea may affect your parole eligibility?
[Yes]
[Yes]
[No]
[No]
[NA]
11. Do you understand that if you have plead guilty to, or have been found guilty
on other charges, or are presently serving a custodial term and the plea
agreement is silent on the issue, the court may require that all sentences be
made to run consecutively?
[Yes]
[No]
[NA]
Defendant’s Initials_______________
Main Plea Form / Revised Form Promulgated by Directive #14-08 (10/08/2008), CN 10079-English
page 2 of 4
12. List any charges the prosecutor has agreed to recommend for dismissal:
Ind./Acc./Compl.#
Count
Nature of Offense and Degree
13. Specify any sentence the prosecutor has agreed to recommend:
14. Has the prosecutor promised that he or she will NOT:
a. Speak at sentencing?
b. Seek an extended term of confinement?
c. Seek a stipulation of parole ineligibility?
[Yes]
[Yes]
[Yes]
[No]
[No]
[No]
15. Are you aware that you must pay restitution if the court finds there is a victim
who has suffered a loss and if the court finds that you are able or will be able
in the future to pay restitution?
[Yes]
[No]
[NA]
16. Do you understand that if you are a public office holder or employee, you can
be required to forfeit your office or job by virtue of your plea of guilty?
[Yes]
[No]
[NA]
[Yes]
[No]
[Yes]
[No]
[Yes]
[No]
[Yes]
[No]
Are you a citizen of the United States?
(If no, answer question #17b)
b. Do you understand that if you are not a United States citizen or national, you may be
deported by virtue of your plea of guilty?
17. a.
Do you understand that pursuant to the rules of the Interstate Compact for Adult
Offender Supervision if you are residing outside the State of New Jersey at the time
of sentencing that return to your residence may be delayed pending acceptance of the
transfer of your supervision by your state of residence?
b. Do you also understand that pursuant to the same Interstate Compact transfer of your
supervision to another state may be denied or restricted by that state at any time after
sentencing if that state determines you are required to register as a sex offender in
that state or if New Jersey has required you to register as a sex offender?
18. a.
19. Have you discussed with your attorney the legal doctrine of merger?
[Yes]
[No]
[NA]
20. Are you giving up your right at sentence to argue that there are charges you
pleaded guilty to for which you cannot be given a separate sentence?
[Yes]
[No]
[NA]
Defendant’s Initials_______________
Main Plea Form / Revised Form Promulgated by Directive #14-08 (10/08/2008), CN 10079-English
page 3 of 4
21. List any other promises or representations that have been made by you, the prosecutor, your defense
attorney, or anyone else as a part of this plea of guilty:
22. Have any promises other than those mentioned on this form, or any threats, been
made in order to cause you to plead guilty?
[Yes]
[No]
[Yes]
[No]
[Yes]
[No]
[Yes]
[No]
24. Are you satisfied with the advice you have received from your lawyer?
[Yes]
[No]
25. Do you have any questions concerning this plea?
[Yes]
[No]
Do you understand that the judge is not bound by any promises or
recommendations of the prosecutor and that the judge has the right to reject the
plea before sentencing you and the right to impose a more severe sentence?
b. Do you understand that if the judge decides to impose a more severe sentence
than recommended by the prosecutor, that you may take back your plea?
c. Do you understand that if you are permitted to take back your plea of guilty
because of the judge’s sentence, that anything you say in furtherance of the
guilty plea cannot be used against you at trial?
23. a.
Date:
Defendant:
Defense Attorney:
Prosecutor:
[ ] This plea is the result of the judge’s conditional indications of the maximum sentence he or she would
impose independent of the prosecutor’s recommendation. Accordingly, the "Supplemental Plea Form for
Non-Negotiated Pleas" has been completed.
Defendant’s Initials_______________
Main Plea Form / Revised Form Promulgated by Directive #14-08 (10/08/2008), CN 10079-English
page 4 of 4
Poder Judicial de Nueva Jersey
Condado
New Jersey Judiciary
County
Formulario de Declaración
Número de archivo del fiscal
Plea Form
Prosecutor File Number
Nombre del acusado
Defendant’s Name:
ante el Juez
before Judge:
1. Enumere los cargos de que usted se declara culpable:
List the charges to which you are pleading guilty:
Máximo estatutario
Statutory Maximum
No. de Ac. Formal /
Ac./Denun.
Cargo
Ind./Acc./Comp.#
Count
Naturaleza de la infracción
Nature of Offense
Grado
Degree
Tiempo
Multa
Time
Fine
Multa de la
VCCA*
VCCA Assmt*
Máx/Max
Máx/Max
Máx/Max
Máx/Max
Máx/Max
Su exposición total como resultado de esta declaración es: .......Total/Total
Your total exposure as the result of this plea is:
Sírvase marcar la respuesta
apropiada con un círculo
Please Circle
Appropriate Answer
2. a. ¿Cometió usted la infracción (las infracciones) de que se declara culpable?
[Sí/Yes]
[No/No]
b. ¿Entiende que antes de que el juez lo pueda encontrar culpable, tendrá que decirle al [Sí/Yes]
juez qué es lo que usted hizo que lo hace culpable de la infracción particular (de las
infracciones particulares)?
[No/No]
Did you commit the offense(s) to which you are pleading guilty?
Do you understand that before the judge can find you guilty, you will have to tell the judge what
you did that makes you guilty of the particular offense(s)?
3. ¿Entiende lo que significan los cargos?
[Sí/Yes]
[No/No]
[Sí/Yes]
[No/No]
[Sí/Yes]
[No/No]
[Sí/Yes]
[No/No]
Do you understand what the charges mean?
4. ¿Entiende que al declararse culpable, usted renuncia a ciertos derechos? Entre ellos
están:
Do you understand that by pleading guilty you are giving up certain rights? Among them are:
a. El derecho a un juicio con jurado en que el Estado tiene que probar su culpabilidad
fuera de duda razonable?
The right to a jury trial in which the State must prove you guilty beyond a reasonable doubt?
b. El derecho de guardar silencio?
The right to remain silent?
c. El derecho a carearse con los testigos en su contra?
The right to confront the witnesses against you?
*
Multa de la Agencia de Compensación a Víctimas de Delitos
/ Victims of Crime Compensation Agency Assessment
Iniciales del acusado / Defendant’s Initials
Formulario principal de declaración / Formulario enmendado promulgado por la directriz #14-08 (10/08/2008), CN 10079-English-Spanish
Main Plea Form / Revised Form Promulgated by Directive #14-08 (10/08/2008), CN 10079-English-Spanish
página 1 de 7
page 1 of 7
4. d. ¿Entiende que al declararse culpable usted no renuncia a su derecho de apelar (1)
la denegación de un pedimento para excluir pruebas físicas (R. 3:5-7(d)) o (2) la
denegación de admisión a un programa de intervención antes del juicio (PTI) (R.
3:28(g))?
[Sí/Yes]
[No/No]
[Sí/Yes]
[No/No]
[Sí/Yes]
[No/No]
[Sí/Yes]
[No/No]
[Sí/Yes]
[No/No]
[Sí/Yes]
[No/No]
Do you understand that by pleading you are not waiving your right to appeal (1) the denial of a
motion to suppress physical evidence (R. 3:5-7(d)) or (2) the denial of acceptance into a pretrial
intervention program (PTI) (R. 3:28(g))?
e. ¿Entiende además que al declararse culpable usted renuncia a su derecho de apelar
la denegación de todos los demás pedimentos previos al juicio excepto los
siguientes:
Do you further understand that by pleading guilty you are waiving your right to appeal the
denial of all other pretrial motions except the following:
5. ¿Entiende que si usted se declara culpable:
Do you understand that if you plead guilty:
a. Tendrá antecedentes penales?
You will have a criminal record?
b. A menos que el convenio declaratorio estipule otra cosa, se le podría sentenciar a
cumplir el tiempo máximo de reclusión, a pagar la multa máxima y a pagar la multa
máxima de la Agencia de Compensación a Víctimas de Delitos?
Unless the plea agreement provides otherwise, you could be sentenced to serve the maximum
time in confinement, to pay the maximum fine and to pay the maximum Victims of Crime
Compensation Agency Assessment?
c. Tendrá que pagar una multa mínima de la Agencia de Compensación a Víctimas de
Delitos de $50 dólares (un mínimo de $100 dólares si se le condena por un delito
violento) por cada cargo de que usted se declara culpable? (La multa es $30 dólares
si la infracción ocurrió entre el 9 de enero de 1986 y el 22 de diciembre de 1991;
$25 dólares si la infracción ocurrió antes del primero de enero de 1986.)
You must pay a minimum Victims of Crime Compensation Agency assessment of $50 ($100
minimum if you are convicted of a crime of violence) for each count to which you plead guilty?
(Penalty is $30 if offense occurred between January 9, 1986 and December 22, 1991 inclusive.
$25 if offense occurred before January 1, 1986.)
d. Si la infracción ocurrió el primero de febrero de 1993 o después de dicha fecha pero
antes del 13 de marzo de 1995 y se le sentencia a libertad a prueba o a un instituto
correccional del estado, usted tendrá que pagar un gasto de transacción de hasta
$1.00 dólar en cada ocasión en que se haga un pago o en que se abone una cuota?
Si la infracción ocurrió el 13 de marzo de 1995 o después de dicha fecha, y se le
sentencia a libertad a prueba, o si la sentencia por otro motivo requiere pagos de
obligaciones económicas a la división de libertad a prueba, usted tendrá que pagar
un gasto de transacción de hasta $2.00 dólares en cada ocasión en que se haga un
pago o se abone una cuota?
If the offense occurred on or after February 1, 1993 but was before March 13, 1995, and you are
being sentenced to probation or a State correctional facility, you must pay a transaction fee of up
to $1.00 for each occasion when a payment or installment payment is made? If the offense
occurred on or after March 13, 1995 and the sentence is to probation, or the sentence otherwise
requires payments of financial obligations to the probation division, you must pay a transaction
fee of up to $2.00 for each occasion when a payment or installment payment is made?
Iniciales del acusado / Defendant’s Initials
Formulario principal de declaración / Formulario enmendado promulgado por la directriz #14-08 (10/08/2008), CN 10079-English-Spanish
Main Plea Form / Revised Form Promulgated by Directive #14-08 (10/08/2008), CN 10079-English-Spanish
página 2 de 7
page 2 of 7
5. e. Si la infracción ocurrió el 2 de agosto de 1993 o después de dicha fecha, usted
tendrá que pagar una multa de $75 dólares al Fondo de Servicios de Vecindarios
Seguros por cada condena?
[Sí/Yes]
[No/No]
[Sí/Yes]
[No/No]
[Sí/Yes]
[No/No]
[Sí/Yes]
[No/No]
6. ¿Entiende que a su discreción el juez podría imponerle un tiempo mínimo de reclusión [Sí/Yes]
que cumplir antes de que pueda aspirar a la libertad condicional, y que ese período
podría ser tan largo como la mitad del período de la sentencia de privación de libertad
que se le haya impuesto a usted?
[No/No]
If the offense occurred on or after August 2, 1993 you must pay a $75 Safe Neighborhood
Services Fund assessment for each conviction?
f. Si la infracción ocurrió el 5 de enero de 1994 o después de dicha fecha y se le
sentencia a libertad a prueba, usted tendrá que pagar un cargo de un máximo de $25
dólares por mes durante el término de la libertad a prueba?
If the offense occurred on or after January 5, 1994 and you are being sentenced to probation, you
must pay a fee of up to $25 per month for the term of probation?
g. Si el delito ocurrió el 9 de enero de 1997 o después de dicha fecha, usted tendrá que
pagar una multa de $30 dólares al Fondo de Capacitación y Equipo de Oficiales del
Orden Público?
If the crime occurred on or after January 9, 1997 you must pay a Law Enforcement Officers
Training and Equipment Fund penalty of $30?
h. Se requerirá que usted suministre y pague el costo del análisis de una muestra de su
ADN que podría ser usada por las autoridades del orden público en la investigación
de actividades delictuosas?
You will be required to provide a DNA sample, which could be used by law enforcement for the
investigation of criminal activity, and pay for the cost of testing?
Do you understand that the court could, in its discretion, impose a minimum time in confinement to
be served before you become eligible for parole, which period could be as long as one half of the
period of the custodial sentence imposed?
7. ¿Presentó usted una declaración de culpabilidad a algún cargo que requiera un
período obligatorio sin posibilidades de libertad condicional o un término obligatorio
prolongado?
[Sí/Yes]
[No/No]
Did you enter a plea of guilty to any charges that require a mandatory period of parole ineligibility
or a mandatory extended term?
a. Si usted se declara culpable de tal cargo, el período mínimo obligatorio sin
años y
meses (llene la
posibilidades de libertad condicional es
cantidad de años/meses) y el período máximo sin posibilidades de libertad
condicional podrá ser de
años y
meses (llene la cantidad de
años/meses) y dicho período no se podrá reducir por créditos por buen
comportamiento, trabajo o custodia mínima.
If you are pleading guilty to such a charge, the minimum mandatory period of parole ineligibility
years and
months (fill in the number of years/months) and the maximum period
is
years and
months (fill in the number of years/months)
of parole ineligibility can be
and this period cannot be reduced by good time, work, or minimum custody credits.
Iniciales del acusado / Defendant’s Initials
Formulario principal de declaración / Formulario enmendado promulgado por la directriz #14-08 (10/08/2008), CN 10079-English-Spanish
Main Plea Form / Revised Form Promulgated by Directive #14-08 (10/08/2008), CN 10079-English-Spanish
página 3 de 7
page 3 of 7
7. b. Si usted se declara culpable de tal cargo, el término obligatorio prolongado mínimo
es
años y
meses (llene la cantidad de años/meses), y el término
obligatorio prolongado máximo puede ser
años y
meses (llene la
cantidad de años/meses).
If you are pleading guilty to such a charge, the minimum mandatory extended term is
months (fill in the number of years/months) and the maximum mandatory
years and
years and
months (fill in the number of years/months).
extended term can be
8. ¿Se declara usted culpable de un delito que conlleva la presunción de encarcelamiento,
lo cual quiere decir que es casi seguro que usted irá a una prisión del estado?
[Sí/Yes]
[No/No]
Are you pleading guilty to a crime that contains a presumption of imprisonment
which means that it is almost certain that you will go to state prison?
9. ¿Actualmente se encuentra usted bajo libertad a prueba o libertad
condicional?
[Sí/Yes]
[No/No]
[Sí/Yes]
[No/No]
[Sí/Yes]
[No/No]
[Sí/Yes]
[No/No]
[No aplica/NA]
[Sí/Yes]
[No/No]
[No aplica/NA]
Are you presently on probation or parole?
a. ¿Se da cuenta usted de que una declaración de culpabilidad podrá
dar por resultado una infracción de su libertad a prueba o bajo
palabra?
[No aplica/NA]
Do you realize that a guilty plea may result in a violation of your probation
or parole?
10. ¿Actualmente está cumpliendo usted una sentencia privativa de
libertad por otro cargo?
Are you presently serving a custodial sentence on another charge?
a. ¿Entiende usted que una declaración de culpabilidad podría
afectar sus posibilidades de conseguir libertad condicional?
Do you understand that a guilty plea may affect your parole eligibility?
11. ¿Entiende usted que si se ha declarado culpable de otros cargos, o lo
han encontrado culpable de otros cargos, o si actualmente está
cumpliendo un término de privación de libertad y el convenio
declaratorio no menciona el tema, el juez podrá requerir que las
sentencias sean consecutivas?
Do you understand that if you have plead guilty to, or have been found guilty
on other charges, or are presently serving a custodial term and the plea
agreement is silent on the issue, the court may require that all sentences be
made to run consecutively?
12. Enumere los cargos que el fiscal haya acordado recomendar que se desestimen:
List any charges the prosecutor has agreed to recommend for dismissal:
No. de Ac. Formal/Ac./Denun.
Ind./Acc./Compl.#
Cargo
Count
Naturaleza y grado de la infracción
Nature of Offense and Degree
Iniciales del acusado / Defendant’s Initials
Formulario principal de declaración / Formulario enmendado promulgado por la directriz #14-08 (10/08/2008), CN 10079-English-Spanish
Main Plea Form / Revised Form Promulgated by Directive #14-08 (10/08/2008), CN 10079-English-Spanish
página 4 de 7
page 4 of 7
13. Especifique cualquier sentencia que el fiscal haya acordado recomendar:
Specify any sentence the prosecutor has agreed to recommend:
14. ¿Ha prometido el fiscal que él o ella NO:
Has the prosecutor promised that he or she will NOT:
a.
Hablará cuando lo sentencien a usted?
[Sí/Yes]
[No/No]
[Sí/Yes]
[No/No]
[Sí/Yes]
[No/No]
Speak at sentencing?
b. Tratará de obtener un término prolongado de reclusión?
Seek an extended term of confinement?
c.
Tratará de obtener la estipulación de que usted no podrá conseguir la libertad
condicional?
Seek a stipulation of parole ineligibility?
15. ¿Sabe usted que tendrá que pagar una restitución si el juez
determina que existe una víctima que ha sufrido una pérdida y si el
juez determina que usted puede o en el futuro podrá pagar una
restitución?
[Sí/Yes]
[No/No]
[No aplica/NA]
[Sí/Yes]
[No/No]
[No aplica/NA]
Are you aware that you must pay restitution if the court finds there is a victim
who has suffered a loss and if the court finds that you are able or will be able
in the future to pay restitution?
16. ¿Entiende usted que si ocupa un cargo público o si es empleado
público, se podrá requerir que renuncie a su cargo o empleo en
virtud de su declaración de culpabilidad?
Do you understand that if you are a public office holder or employee, you can
be required to forfeit your office or job by virtue of your plea of guilty?
17. a. ¿Es usted ciudadano de los Estados Unidos?
(Si no lo es, conteste la pregunta 17b.)
[Sí/Yes]
[No/No]
[Sí/Yes]
[No/No]
Are you a citizen of the United States?
(If no, answer question #17b)
b. ¿Entiende usted que si no posee la ciudadanía o la nacionalidad de los
Estados Unidos, podrá ser deportado en virtud de su declaración de
culpabilidad?
Do you understand that if you are not a United States citizen or national, you may be
deported by virtue of your plea of guilty?
Iniciales del acusado / Defendant’s Initials
Formulario principal de declaración / Formulario enmendado promulgado por la directriz #14-08 (10/08/2008), CN 10079-English-Spanish
Main Plea Form / Revised Form Promulgated by Directive #14-08 (10/08/2008), CN 10079-English-Spanish
página 5 de 7
page 5 of 7
18. a. ¿Entiende que, conforme a las reglas del Acuerdo Interestatal de Supervisión [Sí/Yes]
de Infractores Adultos, si usted reside fuera del estado de Nueva Jersey en el
momento de ser sentenciado, su regreso a su residencia podría demorarse
hasta que su estado de residencia acepte la transferencia de su supervisión?
[No/No]
Do you understand that pursuant to the rules of the Interstate Compact for Adult
Offender Supervision if you are residing outside the State of New Jersey at the time of
sentencing that return to your residence may be delayed pending acceptance of the
transfer of your supervision by your state of residence?
b. ¿Entiende también que, conforme al mismo Acuerdo Interestatal, un estado
puede denegar o restringir la transferencia de su supervisión a ese estado en
cualquier momento después de que haya sido sentenciado si ese estado
determina que se requiere que usted se registre como delincuente sexual en
ese estado o si Nueva Jersey ha requerido que se registre como delincuente
sexual?
[Sí/Yes]
[No/No]
Do you also understand that pursuant to the same Interstate Compact transfer of your
supervision to another state may be denied or restricted by that state at any time after
sentencing if that state determines you are required to register as a sex offender in that
state or if New Jersey has required you to register as a sex offender?
19. ¿Ha hablado usted con su abogado sobre la doctrina legal de fusión?
[Sí/Yes]
[No/No]
[No aplica/NA]
[Sí/Yes]
[No/No]
[No aplica/NA]
Have you discussed with your attorney the legal doctrine of merger?
20. ¿Renuncia usted al derecho que tiene cuando lo sentencien de argüir
que hay cargos de que se declaró culpable para los cuales no se le
puede imponer una sentencia aparte?
Are you giving up your right at sentence to argue that there are charges you
pleaded guilty to for which you cannot be given a separate sentence?
21. Enumere cualquier otra promesa o representación que haya hecho usted, el fiscal, su abogado defensor, o
cualquier otra persona como parte de esta declaración de culpabilidad:
List any other promises or representations that have been made by you, the prosecutor, your defense attorney, or anyone else
as a part of this plea of guilty:
22. ¿Se le ha hecho alguna otra promesa además de las que se mencionan en este
formulario, o alguna amenaza, para conseguir que usted se declare culpable?
[Sí/Yes]
[No/No]
Have any promises other than those mentioned on this form, or any threats, been made in order
to cause you to plead guilty?
Iniciales del acusado / Defendant’s Initials
Formulario principal de declaración / Formulario enmendado promulgado por la directriz #14-08 (10/08/2008), CN 10079-English-Spanish
Main Plea Form / Revised Form Promulgated by Directive #14-08 (10/08/2008), CN 10079-English-Spanish
página 6 de 7
page 6 of 7
23. a.
¿Entiende usted que el juez no se encuentra obligado por ninguna promesa o
recomendación del fiscal y que el juez tiene el derecho de rechazar la
declaración antes de sentenciarlo a usted y el derecho de imponerle una
sentencia mayor?
[Sí/Yes]
[No/No]
[Sí/Yes]
[No/No]
[Sí/Yes]
[No/No]
[Sí/Yes]
[No/No]
[Sí/Yes]
[No/No]
Do you understand that the judge is not bound by any promises or recommendations of
the prosecutor and that the judge has the right to reject the plea before sentencing you and
the right to impose a more severe sentence?
b. ¿Entiende usted que si el juez decide imponerle una sentencia mayor que la
que recomienda el fiscal, usted podrá retractar su declaración?
Do you understand that if the judge decides to impose a more severe sentence than
recommended by the prosecutor, that you may take back your plea?
c.
¿Entiende que si se permite que usted retracte su declaración de culpabilidad
debido a la sentencia del juez, cualquier cosa que usted diga para apoyar la
declaración de culpabilidad no se podrá usar en su contra en un juicio?
Do you understand that if you are permitted to take back your plea of guilty because of
the judge’s sentence, that anything you say in furtherance of the guilty plea cannot be
used against you at trial?
24. ¿Está usted conforme con los consejos que ha recibido de su abogado?
Are you satisfied with the advice you have received from your lawyer?
25. ¿Tiene usted alguna pregunta con respecto a esta declaración?
Do you have any questions concerning this plea?
Fecha:
Acusado
Date
Defendant
Abogado defensor
Defense Attorney
Fiscal
Prosecutor
[ ] Esta declaración es el resultado de las indicaciones condicionales del juez en cuanto a la sentencia máxima
que él o ella impondría sin consideración de la recomendación del fiscal. Por consiguiente, se ha
completado el "Formulario Suplementario para Declaraciones No Negociadas".
This plea is the result of the judge’s conditional indications of the maximum sentence he or she would impose independent
of the prosecutor’s recommendation. Accordingly, the "Supplemental Plea Form for Non-Negotiated Pleas" has been
completed.
Iniciales del acusado / Defendant’s Initials
Formulario principal de declaración / Formulario enmendado promulgado por la directriz #14-08 (10/08/2008), CN 10079-English-Spanish
Main Plea Form / Revised Form Promulgated by Directive #14-08 (10/08/2008), CN 10079-English-Spanish
página 7 de 7
page 7 of 7
ATTACHMENT 2
SUPPLEMENTAL PLEA FORM FOR NONNEGOTIATED PLEAS
ENGLISH AND ENGLISH-SPANISH VERSIONS
New Jersey Judiciary
Supplemental Plea Form for Non-Negotiated Pleas
This form should be filled out only in cases where the defendant is pleading guilty based on the judge's
representation as to what the maximum sentence will be.
1. List any promises or representations that have been made by the judge as to what your sentence will
be.
2. Do you understand that if the judge determines at the time of sentencing that
imposing a sentence no greater than that which he or she promised would not
serve the interests of justice, then the judge may order your plea be vacated or you
will be allowed to withdraw your plea, and your case will proceed to trial.
[Yes]
[No]
Date:
Defendant
Approved by:
(For purposes of plea only)
Judge
Prosecutor
Revised Form Promulgated by Directive #14-08 (10/08/2008), CN 11077-English
page 1 of 1
Poder Judicial de Nueva Jersey
New Jersey Judiciary
Formulario de declaración suplementario para declaraciones no negociadas
Supplemental Plea Form for Non-Negotiated Pleas
Este formulario se debe completar solamente en los casos en que el acusado se está declarando culpable
basado en la manifestación del juez en cuanto a la sentencia máxima que le dará
This form should be filled out only in cases where the defendant is pleading guilty based on the judge's representation as to
what the maximum sentence will be.
1. Enumere cualquier promesa o manifestación que le ha hecho el juez en cuanto a la sentencia que le
dará.
List any promises or representations that have been made by the judge as to what your sentence will be.
2. Entiende que si, en el momento de dictar sentencia, el juez determina que al
[Sí/Yes]
imponer una sentencia no mayor que la que él le prometió, no se tendrían en
cuenta los intereses de la justicia, entonces el juez podrá ordenar que se anule
su declaración, o a usted le permitirán retirar su declaración, y se proseguirá
a conocer su causa.
[No/No]
Do you understand that if the judge determines at the time of sentencing that imposing a
sentence no greater than that which he or she promised would not serve the interests of
justice, then the judge may order your plea be vacated or you will be allowed to
withdraw your plea, and your case will proceed to trial.
Fecha:
Date
Acusado
Defendant
Aprobado por:
Approved by
(Solamente para los efectos de la declaración )
Juez
Judge
(For purposes of plea only)
Fiscal
Prosecutor
Formulario enmendado promulgado por la directriz #14-08 (10/08/2008), CN 11077-English-Spanish
Revised Form Promulgated by Directive #14-08 (10/08/2008), CN 101077-English-Spanish
página 1 de 1
page 1 of 1
ATTACHMENT 3
SUPPLEMENTAL PLEA FORM FOR SEXUAL
OFFENSES
ENGLISH AND ENGLISH-SPANISH VERSIONS
New Jersey Judiciary
Supplemental Plea Form for Sexual Offenses
The following additional questions need to be answered only if you are pleading guilty to an offense of
Aggravated Sexual Assault, Sexual Assault or Aggravated Criminal Sexual Contact or kidnapping
pursuant to N.J.S.A. 2C:13-1c(2) or an attempt to commit one of these crimes.
1. Do you understand you will be required to submit to a physical and psychological [Yes]
examination at the Avenel Diaguostic and Treatment Center the purpose of which
is to detennine if your conduct in committing the offense was characterized by a
pattern of repetitive and compulsive behavior?
[No]
2. Do you understand if the examination reveals that your conduct is characterized
[Yes]
by a pattern of repetitive and compulsive behavior, the judge may sentence you to
confinement at the Adult Diagnostic and Treatment Center for a program of
specialized treatment for your mental condition?
[No]
3. Do you understand you will be able to challenge the findings of the Adult
Diagnostic and Treatment Center in a hearing and that at that hearing you will
have the right to confront the witnesses against you and to cross examine them
and then present evidence on your own behalf?
[Yes]
[No]
[Yes]
[No]
4. Do you understand if you are sentenced to the Adult Diagnostic and Treatment
Center
a. that any future parole will not be guided by the normal parole guidelines?
b.
that you will be eligible for release when the State Parole Board, after
receiving a recommendation from a special classification review board, finds
that you are capable of making an acceptable social adjustment in the
community?
[Yes]
[No]
c.
that you could spend more time in treatment than you would spend if
sentenced to state prison?
[Yes]
[No]
Date:
Defendant:
Defense Attorney:
Prosecutor:
Revised Form Promulgated by Directive #14-08 (10/08/2008), CN 11080-English
page 1 of 1
Poder Judicial de Nueva Jersey
New Jersey Judiciary
Formulario de declaración suplemental para delitos sexuales
Supplemental Plea Form for Sexual Offenses
Es necesario contestar las siguientes preguntas adicionales solamente si usted se está declarando
culpable de un delito de Agresión Sexual con Agravantes, Agresión Sexual o Contacto Sexual Ilícito con
Agravantes o Secuestro conforme a N.J.S.A. 2C:13-1c(2) o el intento de cometer uno de dichos delitos.
The following additional questions need to be answered only if you are pleading guilty to an offense of Aggravated
Sexual Assault, Sexual Assault or Aggravated Criminal Sexual Contact or kidnapping pursuant to N.J.S.A. 2C:13-1c(2)
or an attempt to commit one of these crimes.
1. ¿Entiende usted que se requerirá que se someta a un examen físico y
psicológico en el Centro Diagnóstico y de Tratamiento de Avenel con el
propósito de determinar si su conducta se caracterizaba por un patrón de
comportamiento repetidor y compulsivo cuando cometió el delito?
[Sí/Yes]
[No/No]
2. ¿Entiende usted que si el examen revela que su conducta se caracteriza por un [Sí/Yes]
patrón de comportamiento repetidor y compulsivo, el juez lo podrá sentenciar
a la reclusión en el Centro Diagnóstico y de Tratamiento para un programa de
tratamiento especializado para su condición mental?
[No/No]
Do you understand you will be required to submit to a physical and psychological
examination at the Avenel Diagnostic and Treatment Center the purpose of which is to
determine if your conduct in committing the offense was characterized by a pattern of
repetitive and compulsive behavior?
Do you understand if the examination reveals that your conduct is characterized by a
pattern of repetitive and compulsive behavior, the judge may sentence you to
confinement at the Adult Diagnostic and Treatment Center for a program of specialized
treatment for your mental condition?
3. ¿Entiende usted que podrá disputar en una vista los hallazgos del Centro
Diagnóstico y de Tratamiento y que en esa vista tendrá el derecho de
confrontar a los testigos en su contra, de contrainterrogarlos y entonces de
presentar pruebas a su favor?
[Sí/Yes]
[No/No]
[Sí/Yes]
[No/No]
[Sí/Yes]
[No/No]
Do you understand you will be able to challenge the findings of the Adult Diagnostic
and Treatment Center in a hearing and that at that hearing you will have the right to
confront the witnesses against you and to cross examine them and then present evidence
on your own behalf?
4. ¿Entiende usted que si lo sentencian al Centro Diagnóstico y de Tratamiento
de Adultos
Do you understand if you are sentenced to the Adult Diagnostic and Treatment Center
a.
las pautas normales de libertad condicional no regirán para cualquier
libertad condicional en el futuro
that any future parole will not be guided by the normal parole guidelines?
b.
usted reunirá las condiciones necesarias para que lo pongan en libertad
cuando la Junta Estatal de Libertad Condicional, una vez que reciba la
recomendación de una junta especial de revisión de c1asificaciones,
encuentre que usted es capaz de una adaptación social aceptable en la
comunidad?
that you will be eligible for release when the State Parole Board, after receiving a
recommendation from a special classification review board, finds that you are
capable of making an acceptable social adjustment in the community?
Formulario enmendado promulgado por la directriz #14-08 (10/08/2008), CN 11080-English-Spanish
Revised Form Promulgated by Directive #14-08 (10/08/2008), CN 11080-English-Spanish
página 1 de 2
page 1 of 2
4. c.
usted podría pasar más tiempo bajo tratamiento que el que pasaría si lo
sentenciaran a una prisión estatal?
[Sí/Yes]
[No/No]
that you could spend more time in treatment than you would spend if sentenced to
state prison?
Fecha:
Date
Acusado:
Defendant
Abogado Defensor:
Defense Attorney
Fiscal:
Prosecutor
Formulario enmendado promulgado por la directriz #14-08 (10/08/2008), CN 11080-English-Spanish
Revised Form Promulgated by Directive #14-08 (10/08/2008), CN 11080-English-Spanish
página 2 de 2
page 2 of 2
ATTACHMENT 4
ADDITIONAL QUESTIONS FOR CERTAIN SEXUAL
OFFENSES COMMITTED
ON OR AFTER DECEMBER 1, 1998
ENGLISH AND ENGLISH-SPANISH VERSIONS
New Jersey Judiciary
Additional Questions for Certain Sexual Offenses
Committed On or After December 1, 1998
These additional questions need to be answered if you are pleading guilty to the offense of aggravated
sexual assault, sexual assault, aggravated criminal sexual contact, kidnapping under 2C:13-1c(2),
endangering the welfare of a child by engaging in sexual conduct which would impair or debauch the
morals of the child under 2C:24-4a, endangering the welfare of a child pursuant to 2C:24-4b(4), or any
attempt to commit any such offense.
1. Do you understand you will be required to submit to a psychological examination
by the Department of Corrections the purpose of which is to determine if your
conduct in committing the offense was characterized by a pattern of repetitive
and compulsive behavior and if it was, whether you are amenable to (will benefit
from) sex offender treatment and you are willing to participate in such treatment?
[Yes]
[No]
2. Do you understand if the examination reveals that your conduct is characterized
by a pattern of repetitive and compulsive behavior, and you are amenable to (will
benefit from) sex offender treatment and willing to participate in such treatment,
the judge shall, upon recommendation of the Department of Corrections,
sentence you to confinement at the Adult Diagnostic and Treatment Center for
sex offender treatment; however, if the sentence imposed is greater than 7 years,
you will first be confined at a facility other than the Adult Diagnostic and
Treatment Center?
[Yes]
[No]
3. Do you understand if the court finds your conduct is characterized by a pattern of
repetitive and compulsive behavior and you are not amenable to sex offender
treatment or if you are amenable (will benefit from) but you are not willing to
participate in such treatment, the court will sentence you to a term of
incarceration to be served in another facility which will not provide for sex
offender treatment and in such event, you will not receive commutation time for
good behavior or each work credits for time served in such other facility?
[Yes]
[No]
4. Do you understand you will be able to challenge the findings of the Department
of Corrections in a hearing and at that hearing you will have the right to confront
the witnesses against you and to cross examine them and then present evidence
on your own behalf?
[Yes]
[No]
[Yes]
[No]
5. Do you understand if you are sentenced to the Adult Diagnostic and Treatment
Center
a. that any future parole will not be guided by the normal parole guidelines?
Revised Form Promulgated by Directive #14-08 (10/08/2008), CN 11081-English
page 1 of 2
5. b. that you will be eligible for release when the State Parole Board, after
receiving a recommendation from a special classification review board, finds
you have achieved a satisfactory level of progress in sex offender treatment
and that you will then be released on parole unless the State Parole Board
determines by a preponderance of the evidence that you have failed to
cooperate in your rehabilitation or there is reasonable expectation that you
will violate conditions of parole?
[Yes]
[No]
[Yes]
[No]
6. Do you understand that if you are determined to be a repetitive, compulsive sex
offender who is amenable to (will benefit from) sex offender treatment but you
are not willing to participate in such treatment and are confined to a facility other
than Adult Diagnostic and Treatment Center, you will also be subject to the same
parole eligibility terms as contained in section 5 above?
[Yes]
[No]
7. Do you understand that if your conduct is not characterized by a pattern of
repetitive, compulsive behavior or you are not amenable to sex offender
treatment you will not become primarily eligible for parole until you have served
any mandatory minimum term imposed by the court or one third of the sentence
imposed where no mandatory minimum term is fixed and neither term will be
reduced by commutation time for good behavior or work credits?
[Yes]
[No]
c. that you could spend more time in treatment than you would spend if
sentenced to state prison?
Date:
Defendant:
Defense Attorney:
Prosecutor:
NOTE: If the defendant is a female and qualifies for sex offender treatment, she will not be confined
at the Adult Diagnostic and Treatment Center but a facility designated by the Commissioner of
Corrections where she will receive similar sex offender treatment.
Revised Form Promulgated by Directive #14-08 (10/08/2008), CN 11081-English
page 2 of 2
Poder Judicial de Nueva Jersey
New Jersey Judiciary
Preguntas adicionales para ciertos delitos sexuales
cometidos a partir del primero de diciembre de 1998
Additional Questions for Certain Sexual Offenses
Committed on or After December 1, 1998
Usted tiene que contestar a estas preguntas adicionales si se está declarando culpable del delito de
agresión sexual con agravantes, agresión sexual, contacto sexual criminal con agravantes, rapto según
2C:13-1c(2), poner en peligro el bienestar de un menor participando en una conducta sexual que
perjudique o corrompa la moral del menor según 2C.24-4a, poner en peligro el bienestar de un menor
conforme a 2C.24-4b(4) o del intento de cometer cualquiera de dichos delitos.
These additional questions need to be answered if you are pleading guilty to the offense of aggravated sexual assault,
sexual assault, aggravated criminal sexual contact, kidnapping under 2C:13-1c(2), endangering the welfare of a child by
engaging in sexual conduct which would impair or debauch the morals of the child under 2C:24-4a, endangering the
welfare of a child pursuant to 2C:24-4b(4), or any attempt to commit any such offense.
1. ¿Entiende usted que se requerirá que se someta a un examen psicológico
realizado por el Departamento de Correcciones con el propósito de determinar
si su conducta se caracterizaba por un patrón de comportamiento repetidor y
compulsivo cuando cometió el delito, y de ser así, si usted aceptaría (se
beneficiaría de) un tratamiento para delincuentes sexuales y si usted estaría
dispuesto a participar en dicho tratamiento?
[Sí/Yes]
[No/No]
[Sí/Yes]
[No/No]
Do you understand you will be required to submit to a psychological examination by the
Department of Corrections the purpose of which is to determine if your conduct in
committing the offense was characterized by a pattern of repetitive and compulsive
behavior and if it was, whether you are amenable to (will benefit from) sex offender
treatment and you are willing to participate in such treatment?
2. ¿Entiende usted que si el examen revela que su conducta se caracteriza por un
patrón de comportamiento repetidor y compulsivo, y usted aceptaría (se
beneficiaría de) un tratamiento para delincuentes sexuales y estaría dispuesto a
participar en dicho tratamiento, el juez, ante la recomendación del
Departamento de Correctiones, lo sentenciará a reclusión en el Centro de
Diagnóstico y Tratamiento de Adultos, para tratamiento de delincuentes
sexuales; sin embargo, si la sentencia que le impongan es de más de 7 años,
primero lo recluirán en una institución que no sea el Centro de Diagnóstico y
Tratamiento de Adultos?
Do you understand if the examination reveals that your conduct is characterized by a pattern
of repetitive and compulsive behavior, and you are amenable to (will benefit from) sex
offender treatment and willing to participate in such treatment, the judge shall, upon
recommendation of the Department of Corrections, sentence you to confinement at the
Adult Diagnostic and Treatment Center for sex offender treatment; however, if the sentence
imposed is greater than 7 years, you will first be confined at a facility other than the Adult
Diagnostic and Treatment Center?
Formulario enmendado promulgado por la directriz #14-08 (10/08/2008), CN 11081-English-Spanish
Revised Form Promulgated by Directive #14-08 (10/08/2008), CN 11081-English-Spanish
página 1 de 3
page 1 of 3
3. ¿Entiende que si el juez determina que su conducta se caracteriza por un patrón
de comportamiento repetidor y compulsivo y usted no aceptaría un tratamiento
para delincuentes sexuales o si aceptaría (se beneficiaría de) dicho tratamiento
pero no está dispuesto a participar en él, el juez lo sentenciará a un término de
encarcelamiento que cumplirá en otra institución que no incluirá ningún
tratamiento para delincuentes sexuales y en dicho caso, no se le conmutará el
tiempo por buena conducta ni recibirá créditos de trabajo por el tiempo
cumplido en esa otra institución?
[Sí/Yes] [No/No]
Do you understand if the court finds your conduct is characterized by a pattern of repetitive
and compulsive behavior and you are not amenable to sex offender treatment or if you are
amenable (will benefit from) but you are not willing to participate in such treatment, the
court will sentence you to a term of incarceration to be served in another facility which will
not provide for sex offender treatment and in such event, you will not receive commutation
time for good behavior or each work credits for time served in such other facility?
4. ¿Entiende usted que podrá disputar en una vista los hallazgos del Departamento [Sí/Yes] [No/No]
de Correcciones y que en esa vista tendrá el derecho de confrontar a los testigos
en su contra, de contrainterrogarlos y de presentar pruebas a su favor?
Do you understand you will be able to challenge the findings of the Department of
Corrections in a hearing and at that hearing you will have the right to confront the witnesses
against you and to cross examine them and then present evidence on your own behalf?
5. ¿Entiende usted que si lo sentencian al Centro de Diagnóstico y Tratamiento de
Adultos
Do you understand if you are sentenced to the Adult Diagnostic and Treatment Center
a. las pautas normales de libertad condicional no regirán para cualquier
libertad condicional en el futuro?
[Sí/Yes] [No/No]
that any future parole will not be guided by the normal parole guidelines?
b. usted calificará para que lo pongan en libertad cuando la Junta Estatal de
[Sí/Yes] [No/No]
Libertad Condicional, después de recibir la recomendación de una junta
especial de revisión de clasificaciones, encuentre que usted ha logrado un
nivel satisfactorio de progreso en el tratamiento para delincuentes sexuales y
que entonces lo pondrán en libertad bajo palabra a menos que la Junta
Estatal de Libertad Bajo Palabra determine por una preponderancia de las
pruebas que usted ha dejado de colaborar en su rehabilitación o si es
razonable esperar que usted infrinja las condiciones de libertad condicional?
that you will be eligible for release when the State Parole Board, after receiving a
recommendation from a special classification review board, finds you have achieved a
satisfactory level of progress in sex offender treatment and that you will then be
released on parole unless the State Parole Board determines by a preponderance of the
evidence that you have failed to cooperate in your rehabilitation or there is reasonable
expectation that you will violate conditions of parole?
5. c. que usted podría pasar más tiempo bajo tratamiento que el que pasaría si lo
sentenciaran a la prisión estatal?
[Sí/Yes] [No/No]
that you could spend more time in treatment than you would spend if sentenced to state
prison?
Formulario enmendado promulgado por la directriz #14-08 (10/08/2008), CN 11081-English-Spanish
Revised Form Promulgated by Directive #14-08 (10/08/2008), CN 11081-English-Spanish
página 2 de 3
page 2 of 3
6. ¿Entiende usted que si se determina que es un delincuente sexual repetidor y
[Sí/Yes] [No/No]
compulsivo y que aceptaría (se beneficiaría de) un tratamiento para delincuentes
sexuales pero usted no está dispuesto a participar en dicho tratamiento y queda
recluido en una institución que no sea el Centro de Diagnóstico y Tratamiento
de Adultos, también estará sujeto a los mismos términos que figuran más arriba
en la sección 5 para salir en libertad condicional?
Do you understand that if you are determined to be a repetitive, compulsive sex offender
who is amenable to (will benefit from) sex offender treatment but you are not willing to
participate in such treatment and are confined to a facility other than Adult Diagnostic and
Treatment Center, you will also be subject to the same parole eligibility terms as contained
in section 5 above?
7. ¿Entiende usted que si su conducta no se caracteriza por un patrón de
[Sí/Yes] [No/No]
comportamiento repetidor y compulsivo o si usted no aceptaría recibir
tratamiento para delincuentes sexuales, no calificará para primariamente salir en
libertad condicional hasta que haya cumplido cualquier término mínimo
obligatorio impuesto por el juez o un tercio de la sentencia impuesta cuando no
se haya fijado ningún término mínimo obligatorio y ninguno de los términos
será reducido por tiempo de conmutación por buen comportamiento o créditos
de trabajo?
Do you understand that if your conduct is not characterized by a pattern of repetitive,
compulsive behavior or you are not amenable to sex offender treatment you will not become
primarily eligible for parole until you have served any mandatory minimum term imposed
by the court or one third of the sentence imposed where no mandatory minimum term is
fixed and neither term will be reduced by commutation time for good behavior or work
credits?
Fecha:
Date
Acusado:
Defendant
Abogado Defensor:
Defense Attorney
Fiscal:
Prosecutor
NOTA: Sí se trata de una acusada y ella califica para recibir tratamiento para delincuentes sexuales, no
quedará recluida en el Centro de Diagnóstico y Tratamiento de Adultos sino en una institución designada
por el Comisionado de Correcciones donde recibirá un tratamiento similar para delincuentes sexuales.
NOTE: If the defendant is a female and qualifies for sex offender treatment, she will not be confined at the Adult Diagnostic
and Treatment Center but a facility designated by the Commissioner of Corrections where she will receive similar sex
offender treatment.
Formulario enmendado promulgado por la directriz #14-08 (10/08/2008), CN 11081-English-Spanish
Revised Form Promulgated by Directive #14-08 (10/08/2008), CN 11081-English-Spanish
página 3 de 3
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ATTACHMENT 5
ADDITIONAL QUESTIONS FOR CERTAIN SEXUAL
OFFENSES
(Megan’s Law Plea Form)
ENGLISH AND ENGLISH-SPANISH VERSIONS
New Jersey Judiciary
Additional Questions for Certain Sexual Offenses
These additional questions need to be answered if you are pleading guilty to the offense of aggravated
sexual assault, sexual assault, aggravated criminal sexual contact, kidnapping under 2C:13-1c(2),
endangering the welfare of a child by engaging in sexual conduct which would impair or debauch the
morals of the child under 2C:24-4a, endangering the welfare of a child pursuant to 2C:24-4b(3), (4) or
(5)(a), luring or enticing a child pursuant to 2C:13-6, criminal sexual contact pursuant to 2C:14-3b if the
victim is a minor; kidnapping pursuant to 2C:13-1, criminal restraint pursuant to 2C:13-2 or false
imprisonment pursuant to 2C:13-3 if the victim is a minor and the offender is not the parent, promoting
child prostitution pursuant to 2C:34-1b(3), (4), or any attempt to commit any such offense. Note also
that Question 7 includes the offense of felony murder if the underlying crime is sexual assault, as well as
any offense for which the court makes a specific finding on the record that, based on the circumstances
of the case, the offense should be considered a sexually violent offense, or an attempt to commit these
offenses.
1. Registration
a) Do you understand that you must register with certain public agencies?
[Yes]
[No]
b) Do you understand that if you change residence you must notify the law
enforcement agency where you are registered, and must re-register with the
chief law enforcement officer of the municipality in which you will reside, or
the Superintendent of State Police if the municipality does not have a chief law
enforcement officer, no less than 10 days before you intend to reside at the
new address?
[Yes]
[No]
c) Do you understand that if you fail to register or re-register you may be charged
with a third degree crime and receive a sentence of imprisonment of up to 5
years?
[Yes]
[No]
d) Do you understand that you must provide the appropriate law enforcement
agency with information about your routine access to or use of a computer or
device with Internet capability? (if the offense was committed on or after
February 25, 2008)
[Yes]
[No]
e) Do you understand that if you fail to notify the appropriate law enforcement
agency about your routine access to or use of a computer or device with
Internet capability or a change in such use or access, you may be charged with
a fourth degree crime and may receive a sentence of imprisonment of up to 18
months? (if the offense was committed on or after February 25, 2008)
[Yes]
[No]
Revised Form Promulgated by Directive #14-08 (10/08/2008), CN 10080-English
page 1 of 4
2. Address Verification
a) Do you understand that if you are pleading guilty to aggravated sexual assault,
sexual assault, aggravated criminal sexual contact, kidnapping pursuant to
2C:13-1c(2) or any attempt to commit any of these crimes and at sentencing
the court finds that your conduct was characterized by a pattern of repetitive,
compulsive behavior you must verify your address with the appropriate law
enforcement agency every 90 days or if the court finds your conduct is not
characterized by a pattern of repetitive and compulsive behavior, you must
verify your address annually?
b) Do you understand that if you provide false information concerning your
residence or fail to verify your address you may be charged with a fourth
degree crime and receive a sentence of imprisonment of up to 18 months?
3. Notification
Do you understand that the requirement of registration may result in notification to
law enforcement, community organizations, or the public at large, of your release
from incarceration or presence in the community?
4a. Community Supervision for Life (only complete if the offense occurred before
January 14, 2004). (If the offense occurred on or after January 14, 2004, the
defendant should complete Question 4b, Parole Supervision for Life).
(1) Do you understand that if you are pleading guilty to the crime of aggravated
sexual assault, sexual assault, aggravated criminal sexual contact, kidnapping
pursuant to 2C:13-1c(2), endangering the welfare of a child by engaging in
sexual conduct which would impair or debauch the morals of the child
pursuant to 2C:24-4a, luring, or an attempt to commit any such offense, the
court, in addition to any other sentence, will impose a special sentence of
community supervision for life?
[Yes]
[No]
[Yes]
[No]
[Yes]
[No]
[Yes]
[No]
(2) Do you understand that being sentenced to community supervision
for life means that: you will be supervised for at least 15 years as if
on parole, and subject to conditions appropriate to protect the
public and foster rehabilitation, including, but not limited to
counseling; Internet access or use; and other restrictions, which
may include restrictions on where you can live, work or travel?
[Yes]
[No]
[NA]
(3) Do you understand that the restrictions on where you can live may
include restrictions on residing in a home with minor children?
[Yes]
[No]
[NA]
Revised Form Promulgated by Directive #14-08 (10/08/2008), CN 10080-English
page 2 of 4
4b. Parole Supervision for Life (only complete if the offense occurred on or after
January 14, 2004).
(1) Do you understand that if you are pleading guilty to the crime of
[Yes]
aggravated sexual assault, sexual assault, aggravated criminal
sexual contact, kidnapping pursuant to 2C:13-1c(2), endangering
the welfare of a child by engaging in sexual conduct which would
impair or debauch the morals of a child pursuant to 2C:24-4a,
endangering the welfare of a child pursuant to 2C:24-4b(3), luring
or an attempt to commit any of these offenses and the offense
occurred on or after January 14, 2004, the court, in addition to any
other sentence, will impose a special sentence of parole supervision
for life?
[No]
[NA]
(2) Do you understand that being sentenced to parole supervision for
life means that upon release from incarceration or immediately
upon imposition of a suspended sentence you will be supervised by
the Division of Parole for at least 15 years and will be subject to
provisions and conditions of parole, including conditions
appropriate to protect the public and foster rehabilitation, such as,
but not limited to, counseling, Internet access or use, and other
restrictions which may include restrictions on where you can live,
work, travel or persons you can contact?
[Yes]
[No]
[NA]
(3) Do you understand that the restrictions on where you can live may
include restrictions on residing in a home with minor children?
[Yes]
[No]
[NA]
(4) Do you understand that if you violate a condition of parole
supervision for life, your parole may be revoked and you can be
sent to prison for 12 to 18 months for each revocation that occurs
while you are being supervised and that the prison term you receive
cannot be reduced by commutation or work credits?
[Yes]
[No]
[NA]
(5) Do you understand that if you violate a condition of parole
supervision for life and you are indicted and convicted for that
violation, you will receive a sentence of imprisonment of up to 18
months and that the sentence you receive could be in addition to
any prison term you may receive from the Parole Board for a
violation of parole supervision for life?
[Yes]
[No]
[NA]
[Yes]
[No]
5. Internet Posting
Do you understand that as a result of your conviction your name, age, race, sex,
date of birth, height, weight, eye color, any distinguishing scars or tattoos you
have, your photograph, the make, model, color, year and license plate number of
any vehicle you operate, the street address, zip code, municipality and county in
which you reside and a description of the offense for which you are pleading
guilty, may be publicly available on the Internet?
Revised Form Promulgated by Directive #14-08 (10/08/2008), CN 10080-English
page 3 of 4
6. Statewide Sexual Assault Nurse Examiner Program Penalty
Do you understand that if the crime occurred on or after May 4, 2001 as a result of
your guilty plea you will be required to pay a penalty of $800 for each offense for
which you are pleading guilty?
7. Civil Commitment
Do you understand that if you are convicted of a sexually violent offense, such as
aggravated sexual assault, sexual assault, aggravated criminal sexual contact,
kidnapping under 2C:13-1c(2)(b), criminal sexual contact, felony murder if the
underlying crime is sexual assault, an attempt to commit any of these offenses, or
any offense for which the court makes a specific finding on the record that, based
on the circumstances of the case, the offense should be considered a sexually
violent offense, you may upon completion of your term of incarceration, be civilly
committed to another facility for up to life if the court finds, after a hearing, that
you are in need of involuntary civil commitment?
8. Sex Crime Victim Treatment Fund Penalty (S.C.V.T.F.)
Do you understand that if the crime occurred on or after April 26, 2005, as a result
of your guilty plea you will be required to pay a mandatory Sex Crime Victim
Treatment Fund (S.C.V.T.F.) penalty as listed below for each offense for which
you pled guilty?
[Yes]
[No]
[Yes]
[No]
[Yes]
[No]
b. The mandatory penalties are as follows:
(1) Up to $2,000 in the case of a 1st degree crime
(2) Up to $1,000 in the case of a 2nd degree crime
(3) Up to $ 750 in the case of a 3rd degree crime
(4) Up to $ 500 in the case of a 4th degree crime
TOTAL S.C.V.T.F. Penalty: $
Date:
Defendant:
Defense Attorney:
Prosecutor:
Revised Form Promulgated by Directive #14-08 (10/08/2008), CN 10080-English
page 4 of 4
Poder Judicial de Nueva Jersey
New Jersey Judiciary
Preguntas adicionales para ciertos delitos sexuales
Additional Questions for Certain Sexual Offenses
Usted debe contestar estas preguntas adicionales si se declara culpable del delito de agresión sexual con
agravantes, agresión sexual, abuso deshonesto con agravantes, rapto bajo 2C:13-1c(2), poner en peligro
el bienestar de un niño participando en conducta sexual que perjudique o pervierta la moral del niño bajo
2C:24-4a, poner en peligro el bienestar de un niño conforme a 2C:24-4b(3), (4) o (5)(a), seducir o atraer
con engaño a un niño conforme a 2C:13-6, abuso deshonesto conforme a 2C:14-3b si la víctima es un
menor; rapto conforme a 2C:13-1, constreñimiento ilegal conforme a 2C:13-2 o privación ilegal de
libertad conforme a 2C:13-3 si la víctima es un menor y el infractor no es uno de los padres, fomento de
la prostitución infantil conforme a 2C:34-1b(3), (4), o cualquier intento de cometer cualquiera de dichos
delitos. Tenga en cuenta también que la pregunta 7 incluye el delito de homicidio preterintencional si el
delito subyacente es agresión sexual, así como cualquier delito respecto al cual el juez hace constar en el
acta su decisión específica de que, dadas las circunstancias del caso, dicho delito se debe considerar un
delito de violencia sexual, o un intento de cometer dichos delitos.
These additional questions need to be answered if you are pleading guilty to the offense of aggravated sexual assault,
sexual assault, aggravated criminal sexual contact, kidnapping under 2C:13-1c(2), endangering the welfare of a child by
engaging in sexual conduct which would impair or debauch the morals of the child under 2C:24-4a, endangering the
welfare of a child pursuant to 2C:24-4b(3), (4) or (5)(a), luring or enticing a child pursuant to 2C:13-6, criminal sexual
contact pursuant to 2C:14-3b if the victim is a minor; kidnapping pursuant to 2C:13-1, criminal restraint pursuant to
2C:13-2 or false imprisonment pursuant to 2C:13-3 if the victim is a minor and the offender is not the parent, promoting
child prostitution pursuant to 2C:34-1b(3), (4), or any attempt to commit any such offense. Note also that Question 7
includes the offense of felony murder if the underlying crime is sexual assault, as well as any offense for which the court
makes a specific finding on the record that, based on the circumstances of the case, the offense should be considered a
sexually violent offense, or an attempt to commit these offenses.
1. Registro
Registration
a) ¿Entiende usted que tiene que registrarse con ciertas agencias públicas?
[Sí/Yes]
[No/No]
[Sí/Yes]
[No/No]
[Sí/Yes]
[No/No]
Do you understand that you must register with certain public agencies?
b) ¿Entiende usted que si cambia de residencia tiene que notificar a la agencia
del orden público donde está registrado y tiene que volver a registrarse con
el oficial principal del orden público del municipio en que usted residirá, o
con el Superintendente de la Policía Estatal si el municipio no tiene un
oficial principal del orden público, por lo menos 10 días antes de la fecha en
que usted piensa residir en la dirección nueva?
Do you understand that if you change residence you must notify the law enforcement
agency where you are registered, and must re-register with the chief law enforcement
officer of the municipality in which you will reside, or the Superintendent of State
Police if the municipality does not have a chief law enforcement officer, no less than
10 days before you intend to reside at the new address?
c) ¿Entiende usted que si deja de registrarse o volver a registrarse, se le podrá
acusar de haber cometido un delito de tercer grado y podrá recibir una
sentencia de encarcelación de un máximo de 5 años?
Do you understand that if you fail to register or re-register you may be charged with a
third degree crime and receive a sentence of imprisonment of up to 5 years?
Formulario enmendado promulgado por la directriz #14-08 (10/08/2008), CN 10080-English-Spanish
Revised Form Promulgated by Directive #14-08 (10/08/2008), CN 10080-English-Spanish
página 1 de 7
page 1 of 7
1. d) ¿Entiende usted que debe suministrar a la agencia apropiada del orden
público información sobre su acceso habitual o uso de una computadora o
un aparato con capacidad de Internet? (si el delito se cometió el 25 de
febrero del 2008 o después de esa fecha)
[Sí/Yes]
[No/No]
[Sí/Yes]
[No/No]
[Sí/Yes]
[No/No]
[Sí/Yes]
[No/No]
Do you understand that you must provide the appropriate law enforcement agency with
information about your routine access to or use of a computer or device with Internet
capability? (if the offense was committed on or after February 25, 2008)
e) ¿Entiende usted que si no notifica a la agencia apropiada del orden público
sobre su acceso habitual o uso de una computadora o un aparato con
capacidad de Internet o sobre un cambio en dicho uso o acceso, lo podrán
acusar de un delito de cuarto grado y podrá recibir una sentencia de
encarcelamiento de un máximo de 18 meses? (si el delito se cometió el 25
de febrero del 2008 o después de esa fecha)
Do you understand that if you fail to notify the appropriate law enforcement agency
about your routine access to or use of a computer or device with Internet capability or a
change in such use or access, you may be charged with a fourth degree crime and may
receive a sentence of imprisonment of up to 18 months? (if the offense was
committed on or after February 25, 2008)
2. Verificación de su dirección
Address Verification
a) ¿Entiende que si usted se declara culpable de agresión sexual con
agravantes, agresión sexual, abuso deshonesto con agravantes, rapto
conforme a 2C:13-1c(2) o cualquier intento de cometer cualquiera de
dichos delitos, y cuando lo sentencien el juez encuentra que su conducta se
caracterizaba por un patrón de comportamiento reincidente y compulsivo,
usted tiene que verificar su dirección con la agencia apropiada del orden
público cada 90 días, o si el juez encuentra que su conducta no se
caracteriza por un patrón de comportamiento reincidente y compulsivo,
usted tiene que verificar su dirección una vez al año?
Do you understand that if you are pleading guilty to aggravated sexual assault, sexual
assault, aggravated criminal sexual contact, kidnapping pursuant to 2C:13-1c(2) or any
attempt to commit any of these crimes and at sentencing the court finds that your
conduct was characterized by a pattern of repetitive, compulsive behavior you must
verify your address with the appropriate law enforcement agency every 90 days or if
the court finds your conduct is not characterized by a pattern of repetitive and
compulsive behavior, you must verify your address annually?
b) ¿Entiende usted que si suministra información falsa sobre su residencia o
deja de verificar su dirección, se le podrá acusar de haber cometido un
delito de cuarto grado y podrá recibir una sentencia de encarcelación de un
máximo de 18 meses?
Do you understand that if you provide false information concerning your residence or
fail to verify your address you may be charged with a fourth degree crime and receive
a sentence of imprisonment of up to 18 months?
Formulario enmendado promulgado por la directriz #14-08 (10/08/2008), CN 10080-English-Spanish
Revised Form Promulgated by Directive #14-08 (10/08/2008), CN 10080-English-Spanish
página 2 de 7
page 2 of 7
3. Notificación
Notification
¿Entiende usted que el requerimiento de registro podrá dar por resultado que se
notifique a agencias del orden público, a organizaciones en la comunidad o al
público en general, de que salió en libertad o de su presencia en la comunidad?
[Sí/Yes]
[No/No]
[Sí/Yes]
[No/No]
Do you understand that the requirement of registration may result in notification to law
enforcement, community organizations, or the public at large, of your release from
incarceration or presence in the community?
4a. Supervisión de por vida en la comunidad (conteste solamente si el delito
ocurrió antes del 14 de enero del 2004). (Si el delito ocurrió el 14 de enero
del 2004 o después de esa fecha, el acusado debe contestar la pregunta 4b,
Supervisión bajo libertad condicional de por vida.)
Community Supervision for Life (only complete if the offense occurred before January
14, 2004). (If the offense occurred on or after January 14, 2004, the defendant should
complete Question 4b, Parole Supervision for Life).
4a. (1) ¿Entiende usted que si se declara culpable de un delito de agresión sexual
con agravantes, agresión sexual, abuso deshonesto con agravantes, rapto
conforme a 2C:13-1c(2), poner en peligro el bienestar de un niño
participando en conducta sexual que perjudique o pervierta la moral del
niño conforme a 2C:24-4a, seducir, o el intento de cometer cualquiera de
dichos delitos, el juez, además de cualquier otra sentencia, le impondrá una
sentencia especial de supervisión de por vida en la comunidad?
Do you understand that if you are pleading guilty to the crime of aggravated sexual
assault, sexual assault, aggravated criminal sexual contact, kidnapping pursuant to
2C:13-1c(2), endangering the welfare of a child by engaging in sexual conduct which
would impair or debauch the morals of the child pursuant to 2C:24-4a, luring, or an
attempt to commit any such offense, the court, in addition to any other sentence, will
impose a special sentence of community supervision for life?
(2) ¿Entiende usted que la sentencia de supervisión de por vida [Sí/Yes] [No/No] [No aplica/NA]
en la comunidad significa que: usted estará bajo supervisión
durante un mínimo de 15 años como si se encontrara en
libertad condicional y estará sujeto a las condiciones que
sean apropiadas para proteger al público y promover su
rehabilitación, que incluirán pero no se limitarán a
asesoramiento; acceso a Internet o su uso; y a otras
restricciones que podrán incluir restricciones en cuanto a
dónde usted podrá vivir, trabajar o viajar?
Do you understand that being sentenced to community supervision
for life means that: you will be supervised for at least 15 years as if
on parole, and subject to conditions appropriate to protect the
public and foster rehabilitation, including, but not limited to
counseling; Internet access or use; and other restrictions, which
may include restrictions on where you can live, work or travel?
(3) ¿Entiende usted que las restricciones en cuanto a dónde podrá vivir
[Sí/Yes] [No/No] [No aplica/NA]
pueden incluir restricciones en cuanto a residir en un hogar con
menores?
Do you understand that the restrictions on where you can live may
include restrictions on residing in a home with minor children?
Formulario enmendado promulgado por la directriz #14-08 (10/08/2008), CN 10080-English-Spanish
Revised Form Promulgated by Directive #14-08 (10/08/2008), CN 10080-English-Spanish
página 3 de 7
page 3 of 7
4b. Supervisión bajo libertad condicional de por vida (conteste solamente si el
delito ocurrió el 14 de enero del 2004 o después de esa fecha).
Parole Supervision for Life (only complete if the offense occurred on or after January
14, 2004).
(1) ¿Entiende usted que si se declara culpable de un delito de
[Sí/Yes] [No/No] [No aplica/NA]
agresión sexual con agravantes, agresión sexual, abuso
deshonesto con agravantes, rapto conforme a 2C:13-1c(2),
poner en peligro el bienestar de un niño participando en
conducta sexual que perjudique o pervierta la moral del niño
conforme a 2C:24-4a, poner en peligro el bienestar de un
niño conforme a 2C:24-4b(3), seducir, o el intento de
cometer cualquiera de dichos delitos, y el delito ocurrió el 14
de enero del 2004 o después de esa fecha, el juez, además de
cualquier otra sentencia, le impondrá una sentencia especial
de supervisión bajo libertad condicional de por vida?
Do you understand that if you are pleading guilty to the crime of
aggravated sexual assault, sexual assault, aggravated criminal sexual
contact, kidnapping pursuant to 2C:13-1c(2), endangering the
welfare of a child by engaging in sexual conduct which would impair
or debauch the morals of a child pursuant to 2C:24-4a, endangering
the welfare of a child pursuant to 2C:24-4b(3), luring or an attempt to
commit any of these offenses and the offense occurred on or after
January 14, 2004, the court, in addition to any other sentence, will
impose a special sentence of parole supervision for life?
(2) ¿Entiende usted que la sentencia de supervisión bajo libertad [Sí/Yes] [No/No] [No aplica/NA]
condicional de por vida significa que al ser puesto en libertad
después de su encarcelación o enseguida de la imposición de
una sentencia suspendida, será supervisado por la División de
Libertad Condicional por un mínimo de 15 años y estará
sujeto a las disposiciones y condiciones de la libertad
condicional, que incluirán las condiciones que sean
apropiadas para proteger al público y promover la
rehabilitación, y que dichas condiciones podrán incluir pero
no se limitarán al asesoramiento, el acceso a Internet o su uso
y otras restricciones entre las que podría haber restricciones
en cuanto a dónde usted podrá vivir, trabajar, viajar o las
personas con quienes podrá comunicarse?
Do you understand that being sentenced to parole supervision for life
means that upon release from incarceration or immediately upon
imposition of a suspended sentence you will be supervised by the
Division of Parole for at least 15 years and will be subject to
provisions and conditions of parole, including conditions appropriate
to protect the public and foster rehabilitation, such as, but not limited
to, counseling, Internet access or use, and other restrictions which
may include restrictions on where you can live, work, travel or
persons you can contact?
Formulario enmendado promulgado por la directriz #14-08 (10/08/2008), CN 10080-English-Spanish
Revised Form Promulgated by Directive #14-08 (10/08/2008), CN 10080-English-Spanish
página 4 de 7
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4b. (3) ¿Entiende que las restricciones en cuanto a dónde podrá vivir [Sí/Yes] [No/No] [No aplica/NA]
pueden incluir restricciones en cuanto a residir en un hogar
con menores?
Do you understand that the restrictions on where you can live may
include restrictions on residing in a home with minor children?
(4) ¿Entiende usted que si infringe una condición de la
supervisión bajo libertad condicional de por vida, le podrán
revocar la libertad condicional y lo podrán enviar a la cárcel
por un período entre 12 y 18 meses por cada revocación que
ocurra mientras lo están supervisando, y que el término de
encarcelación que reciba no se podrá reducir por
conmutación o créditos por trabajo?
[Sí/Yes] [No/No] [No aplica/NA]
Do you understand that if you violate a condition of parole
supervision for life, your parole may be revoked and you can be sent
to prison for 12 to 18 months for each revocation that occurs while
you are being supervised and that the prison term you receive cannot
be reduced by commutation or work credits?
(5) ¿Entiende usted que si infringe una condición de la
[Sí/Yes] [No/No] [No aplica/NA]
supervisión bajo libertad condicional de por vida y se le
acusa formalmente y se le condena por dicha infracción,
recibirá una sentencia de encarcelación que puede ser de un
máximo de 18 meses, y que la sentencia que usted reciba
puede ser agregada a cualquier término de encarcelación que
pueda recibir de la Junta de Libertad Condicional por una
infracción de la supervisión bajo libertad condicional de por
vida?
Do you understand that if you violate a condition of parole
supervision for life and you are indicted and convicted for that
violation, you will receive a sentence of imprisonment of up to 18
months and that the sentence you receive could be in addition to any
prison term you may receive from the Parole Board for a violation of
parole supervision for life?
5. Divulgación en el Internet
Internet Posting
¿Entiende usted que como resultado de su condena, pueden estar públicamente
disponibles en el Internet su nombre y apellido, edad, raza, sexo, fecha de
nacimiento, estatura, peso, color de los ojos, cualquier cicatriz o tatuaje
particular que tenga, su fotografía, la marca, el modelo, el color, año y número
de la placa de cualquier vehículo que opere, la dirección, código postal,
municipio y condado en que reside y una descripción del delito del que se está
declarando culpable?
[Sí/Yes]
[No/No]
Do you understand that as a result of your conviction your name, age, race, sex, date of
birth, height, weight, eye color, any distinguishing scars or tattoos you have, your
photograph, the make, model, color, year and license plate number of any vehicle you
operate, the street address, zip code, municipality and county in which you reside and a
description of the offense for which you are pleading guilty, may be publicly available on
the Internet?
Formulario enmendado promulgado por la directriz #14-08 (10/08/2008), CN 10080-English-Spanish
Revised Form Promulgated by Directive #14-08 (10/08/2008), CN 10080-English-Spanish
página 5 de 7
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6. Multa del programa estatal de enfermeras examinadoras de víctimas de
agresiones sexuales
Statewide Sexual Assault Nurse Examiner Program Penalty
¿Entiende usted que si el delito ocurrió el 4 de mayo de 2001 o después de esa
fecha, como resultado de su declaración de culpabilidad, se requerirá que pague
una multa de $800 por cada delito del cual se está declarando culpable?
[Sí/Yes]
[No/No]
¿Entiende usted que si lo condenan por un delito de violencia sexual, como por
[Sí/Yes]
ejemplo agresión sexual con agravantes, agresión sexual, abuso deshonesto con
agravantes, rapto conforme a 2C:13-1c(2)(b), abuso deshonesto, homicidio
preterintencional si el delito subyacente es agresión sexual, un intento de
cometer cualquiera de dichos delitos o cualquier delito respecto al cual el juez
hace constar en el acta su decisión específica de que, dadas las circunstancias del
caso, el delito se debe considerar un delito de violencia sexual, cuando usted
cumpla su término de encarcelamiento, es posible que lo confinen mediante un
proceso civil en otra instalación hasta de por vida si después de una audiencia el
juez decide que un confinamiento civil involuntario es necesario para usted?
[No/No]
Do you understand that if the crime occurred on or after May 4, 2001 as a result of your
guilty plea you will be required to pay a penalty of $800 for each offense for which you are
pleading guilty?
7. Confinamiento civil
Civil Commitment
Do you understand that if you are convicted of a sexually violent offense, such as
aggravated sexual assault, sexual assault, aggravated criminal sexual contact, kidnapping
under 2C:13-1c(2)(b), criminal sexual contact, felony murder if the underlying crime is
sexual assault, an attempt to commit any of these offenses, or any offense for which the
court makes a specific finding on the record that, based on the circumstances of the case, the
offense should be considered a sexually violent offense, you may upon completion of your
term of incarceration, be civilly committed to another facility for up to life if the court finds,
after a hearing, that you are in need of involuntary civil commitment?
8. Multas del fondo para el tratamiento de víctimas de delitos sexuales
(S.C.V.T.F.)
Sex Crime Victim Treatment Fund Penalty (S.C.V.T.F.)
¿Entiende usted que si el delito ocurrió el 26 de abril del 2005 o después de
esa fecha, a consecuencia de su declaración de culpabilidad usted tendrá que
pagar una multa obligatoria para el Fondo para el Tratamiento de Víctimas de
Delitos Sexuales (S.C.V.T.F.), tal como se indica a continuación, por cada
delito del cual usted se declaró culpable?
[Sí/Yes]
[No/No]
Do you understand that if the crime occurred on or after April 26, 2005, as a result of
your guilty plea you will be required to pay a mandatory Sex Crime Victim Treatment
Fund (S.C.V.T.F.) penalty as listed below for each offense for which you pled guilty?
Formulario enmendado promulgado por la directriz #14-08 (10/08/2008), CN 10080-English-Spanish
Revised Form Promulgated by Directive #14-08 (10/08/2008), CN 10080-English-Spanish
página 6 de 7
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8. b.
Las multas obligatorias son las siguientes:
The mandatory penalties are as follows:
(1) Un máximo de $2,000 por un delito de 1er grado
Up to $2,000 in the case of a 1st degree crime
(2) Un máximo de $1,000 por un delito de 2º grado
Up to $1,000 in the case of a 2nd degree crime
(3) Un máximo de $ 750 por un delito de 3er grado
Up to $ 750 in the case of a 3rd degree crime
(4) Un máximo de $ 500 por un delito de 4º grado
Up to $ 500 in the case of a 4th degree crime
Multa TOTAL de S.C.V.T.F $
TOTAL S.C.V.T.F. Penalty:
Fecha:
Date:
Acusado:
Defendant:
Abogado defensor:
Defense Attorney:
Fiscal:
Prosecutor:
Formulario enmendado promulgado por la directriz #14-08 (10/08/2008), CN 10080-English-Spanish
Revised Form Promulgated by Directive #14-08 (10/08/2008), CN 10080-English-Spanish
página 7 de 7
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ATTACHMENT 6
SUPPLEMENTAL PLEA FORM FOR DRUG
OFFENSES
ENGLISH AND ENGLISH-SPANISH VERSIONS
New Jersey Judiciary
Supplemental Plea Form for Drug Offenses
The following additional questions need to be answered only if you are pleading guilty pursuant to an
offense under N.J.S.A. 2C:35-1 et seq. or N.J.S.A. 2C:36-1 et seq.
1. Have you and the Prosecutor entered into any agreement to provide for
a lesser sentence or period of parole ineligibility than would otherwise
be required? (If yes, be sure to include in questions 12 and 13 above).
[Yes]
[No]
a. You will be required to forfeit your driver’s license for a period of
time from 6 to 24 months, unless the court finds compelling
circumstances warranting an exception?
[Yes]
[No]
b. You will be required to pay a forensic laboratory fee of $50 for each
offense for which you plead guilty?
[Yes]
[No]
c. You will be required to pay a mandatory drug enforcement and
demand reduction (D.E.D.R.) penalty as listed below for each
offense for which you plead guilty?
[Yes]
[No]
2. Do you understand that if you plead guilty:
The mandatory penalties are as follows:
(1) $3,000 in the case of a 1st degree crime
(2) $2,000 in the case of a 2nd degree crime
(3) $1,000 in the case of a 3rd degree crime
(4) $ 750 in the case of a 4th degree crime
(5) $ 500 in the case of a disorderly persons or petty
disorderly persons offense
TOTAL D.E.D.R. Penalty
Date:
Defense Attorney:
Prosecutor:
$
Defendant:
Revised Form Promulgated by Directive # 14-08 (10/08/2008), CN 11000-English
Poder Judicial de Nueva Jersey
New Jersey Judiciary
Formulario de declaración suplemental para delitos relacionados con drogas
Supplemental Plea Form for Drug Offenses
Es necesario contestar las siguientes preguntas adicionales solamente si usted se declara culpable de un
delito conforme a N.J.S.A. 2C:35-1 et seq. o N.J.S.A. 2C:36-1 et seq.
The following additional questions need to be answered only if you are pleading guilty pursuant to an offense under
N.J.S.A. 2C:35-1 et seq. or N.J.S.A. 2C:36-1 et seq.
1.
¿Se han comprometido por algún acuerdo usted y el fiscal a que se estipule una [Sí/Yes] [No/No]
sentencia o un período en que no podrá recibir libertad condicional menores a
los que de otro modo se requerirían? (En caso afirmativo, asegúrese de incluirlo
en las preguntas 12 y 13 que anteceden).
Have you and the Prosecutor entered into any agreement to provide for a lesser sentence or
period of parole ineligibility than would otherwise be required? (If yes, be sure to include
in questions 12 and 13 above).
2.
¿Entiende que si se declara culpable:
Do you understand that if you plead guilty:
a. se requerirá que usted pierda su licencia de conducir por un período de 6 a
24 meses, a menos que el juez determine que existen circunstancias
apremiantes que justifiquen una excepción?
[Sí/Yes] [No/No]
You will be required to forfeit your driver’s license for a period of time from 6 to 24
months, unless the court finds compelling circumstances warranting an exception?
b. se requerirá que usted pague un cargo de $50 del laboratorio forense por
cada delito de que se declara culpable?
[Sí/Yes] [No/No]
You will be required to pay a forensic laboratory fee of $50 for each offense for which
you plead guilty?
c. se requerirá que pague una multa antinarcótica y de reducción de la
demanda (D.E.D.R.) obligatoria por cada delito de que se declara culpable?
[Sí/Yes] [No/No]
You will be required to pay a mandatory drug enforcement and demand reduction
(D.E.D.R.) penalty as listed below for each offense for which you plead guilty?
Las multas obligatorias son las siguientes:
The mandatory penalties are as follows:
(1) $3,000
en el caso de un delito de primer grado
in the case of a 1st degree crime
(2) $2,000
en el caso de un delito de segundo grado
(3) $1,000
en el caso de un delito de tercer grado
(4) $ 750
en el caso de un delito de cuarto grado
(5) $ 500
en el caso de un delito de alteración del orden público o un delito menor de alteración
del orden público
in the case of a 2nd degree crime
in the case of a 3rd degree crime
in the case of a 4th degree crime
in the case of a disorderly persons or petty disorderly persons offense
MULTA TOTAL de D.E.D.R.
TOTAL D.E.D.R. Penalty
Fecha
Date
Acusado:
Defendant
Abogado Defensor:
Defense Attorney
Fiscal:
Prosecutor
Formulario enmendado promulgado por la directriz # 14-08 (10/08/2008), CN 11000-English-Spanish
Revised Form Promulgated by Directive # 14-08 (10/08/2008), CN 11000-English-Spanish
ATTACHMENT 7
SUPPLEMENTAL PLEA FORM FOR THEFT OF A
MOTOR VEHICLE AND UNLAWFUL TAKING OF A
MOTOR VEHICLE
ENGLISH AND ENGLISH-SPANISH VERSIONS
New Jersey Judiciary
Supplemental Plea Form for Theft of a Motor Vehicle or
Unlawful Taking of a Motor Vehicle (N.J.S.A. 2C:20-2.1)
The following questions need to be answered only if you are pleading guilty for violation of N.J.S.A.
2C:20-2 for theft of an automobile and the offense occurred on or after April 2, 1991, or for a violation
of N.J.S.A. 2C:20-10 for unlawful taking of a motor vehicle ("Joyriding") and the offense occurred on or
after August 2, 1993.
1. Do you understand that if you plead guilty you will be required to forfeit
your driver’s license?
[Yes]
[No]
[Yes]
[No]
[Yes]
[No]
1st Offense - 1 year license suspension
2nd Offense - 2 year license suspension
3rd or Subsequent Offense - 10 year license suspension
2. Do you understand that if you plead guilty you will be required to pay a
mandatory penalty?
The mandatory penalties are as follows:
1st Offense
$ 500
2nd Offense
$ 750
3rd or Subsequent offense
$1,000
Total Penalty
$
3. Do you understand that if you plead guilty to more than one theft of an
automobile or unlawful taking of a motor vehicle that the license
forfeitures and mandatory penalties imposed can be consecutive to each
other?
Date
Defendant
Defense Attorney
Prosecutor
Revised Form Promulgated by Directive #14-08 (10/08/2008), CN 11168-English
page 1 of 1
Poder Judicial de Nueva Jersey
New Jersey Judiciary
Suplemento al formulario de declaración de culpabilidad por robo de un vehículo
motorizado o la retención ilegal de un vehículo motorizado (N.J.S.A. 2C:20-2.1)
Supplemental Plea Form for Theft of a Motor Vehicle or
Unlawful Taking of a Motor Vehicle (N.J.S.A. 2C:20-2.1)
Hay que contestar a las siguientes preguntas solamente si usted se declara culpable de infringir N.J.S.A.
2C:20-2 por el robo de un automóvil y la infracción ocurrió a partir del 2 de abril de 1991, o por
infringir N.J.S.A. 2C:20-10 por la retención ilegal de un vehículo de motor (el manejo imprudente de un
auto ajeno sin el permiso del dueño - “joyriding”) y la infracción ocurrió a partir del 2 de agosto de
1993.
The following questions need to be answered only if you are pleading guilty for violation of N.J.S.A. 2C:20-2 for theft of
an automobile and the offense occurred on or after April 2, 1991, or for a violation of N.J.S.A. 2C:20-10 for unlawful
taking of a motor vehicle ("Joyriding") and the offense occurred on or after August 2, 1993.
1. ¿Entiende que si se declara culpable tendrá que devolver su licencia de
conducir?
[Sí/Yes]
[No/No]
[Sí/Yes]
[No/No]
[Sí/Yes]
[No/No]
Do you understand that if you plead guilty you will be required to forfeit your
driver’s license?
1ra infracción - suspensión de la licencia por 1 año
1st Offense - 1 year license suspension
2da infracción - suspensión de la licencia por 2 años
2nd Offense - 2 year license suspension
3ra infracción o subsiguiente - suspensión de la licencia por 10 años
3rd or Subsequent Offense - 10 year license suspension
2. ¿ Entiende que si se declara culpable tendrá que pagar una multa
obligatoria?
Do you understand that if you plead guilty you will be required to pay a mandatory
penalty?
Las multas obligatorias son las siquientes:
The mandatory penalties are as follows:
1ra infracción
$ 500
1st Offense
2da infracción
$ 750
2nd Offense
3ra infracción o subsiguiente
$1,000
3rd or Subsequent offense
Multa total
$
Total Penalty
3. ¿Entiende que si se declara culpable del robo de más de un automóvil o de
más de una retención ilegal de un vehículo de motor, las pérdidas de
licencia y las multas obligatorias que se impongan podrán ser consecutivas
las unas a las otras?
Do you understand that if you plead guilty to more than one theft of an automobile or
unlawful taking of a motor vehicle that the license forfeitures and mandatory
penalties imposed can be consecutive to each other?
Fecha
Date
Acusado
Defendant
Abogado Defensor
Defense Attorney
Fiscal
Prosecutor
Formulario enmendado promulgado por la directriz #14-08 (10/08/2008)CN 11168-English-Spanish
Revised Form Promulgated by Directive #14-08 (10/08/2008), CN 11168-English-Spanish
página 1 de 1
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ATTACHMENT 8
ADDITIONAL QUESTIONS FOR CERTAIN DRUG
AND WEAPONS OFFENSES COMMITTED ON OR
AFTER JUNE 24, 1998
ENGLISH AND ENGLISH-SPANISH VERSIONS
New Jersey Judiciary
Additional Questions for Certain Drug and Weapons Offenses
Committed on or After June 24, 1998
The following questions need to be answered if you are pleading guilty to certain drug offenses and also
are pleading guilty to possession of a firearm or other weapon while committing, attempting to commit
or conspiring to commit any of the following offenses. If a firearm was possessed, answer questions 1
a, b and c. If a firearm was not possessed, mark question 1a not applicable [NA] and answer questions
1b and c.
1. Do you understand that if you plead guilty to any of the following offenses: leader of a narcotics
trafficking network (2C:35-3); operating a controlled dangerous substance production facility
(2C:35-4); manufacturing a controlled dangerous substance (2C:35-5) distribution, possession or
manufacture of gamma hydroxybututyrate (2C:35-5.2); distribution, possession or manufacture of
flunitrazepam (2C:35-5.3); employing a juvenile in drug distribution (2C:35-6); distributing,
dispensing or possessing with intent to distribute a controlled dangerous substance within 1,000 feet
of school property (2C:35-7); distributing, dispensing or possessing a controlled dangerous
substance within 500 feet of a public housing facility, park or building (2C:35-7.1); or, distribution,
possession or manufacture of an imitation controlled dangerous substance (2C:35-11)
AND
a. you also plead guilty to possessing a firearm while
committing, attempting to commit or conspiring to commit
any of these offenses you will receive a consecutive
sentence for possessing the weapon?
[Yes]
[No]
[NA]
[Yes]
[No]
[NA]
[Yes]
[No]
[NA]
OR
b. you also plead guilty to possessing a weapon, other than a
firearm, for an unlawful purpose while committing,
ttempting to commit or conspiring to commit any of these
offenses you will receive a consecutive sentence for
possessing the weapon for an unlawful purpose?
OR
c. you also plead guilty to possessing a weapon, other than a
firearm, under circumstances not manifestly appropriate for
lawful use of the weapon while committing, attempting to
commit or conspiring to commit any of these offenses you
will receive a consecutive sentence for possessing the
weapon?
Date
Defendant
Defense Attorney
Prosecutor
Revised Form Promulgated by Directive #14-08 (10/08/2008), CN 11169-English
page 1 of 1
Poder Judicial de Nueva Jersey
New Jersey Judiciary
Preguntas Adicionales Para Ciertos Actos Criminales Relacionados Con Drogas Y
Armas Que Se Cometieron El 24 De Junio De 1998 O Después De Esa Fecha
Additional Questions for Certain Drug and Weapons Offenses
Committed on or After June 24, 1998
Es necesario contestar a las siguientes preguntas si Ud. se declara culpable de ciertos actos criminales
relacionados con drogas y también se declara culpable de la posesión de un arma de fuego u otra arma
mientras cometió, trató de cometer o conspiró para cometer cualquiera de los siguientes actos
criminales. Si poseía un arma de fuego, conteste a las preguntas 1 a, b y c. Si no poseía un arma de
fuego, indique que la pregunta 1a no le incumbe [NA] y conteste a las preguntas 1b y c.
The following questions need to be answered if you are pleading guilty to certain drug offenses and also are pleading
guilty to possession of a firearm or other weapon while committing, attempting to commit or conspiring to commit any of
the following offenses. If a firearm was possessed, answer questions 1 a, b and c. If a firearm was not possessed, mark
question 1a not applicable [NA] and answer questions 1b and c.
1. Entiende que si Ud. se declara culpable de cualquiera de los siguientes actos criminales: líder de una
red de tráfico de narcóticos (2C:35-3); operación de una instalación de producción de una sustancia
peligrosa regulada (2C:35-4); fabricación de una sustancia peligrosa regulada (2C:35-5);
distribución, posesión o fabricación de gamma hidroxibutirato (2C:35-5.2); distribución, posesión o
fabricación de flunitracepam (2C:35-5.3); utilización de un menor en la distribución de drogas
(2C:35-6); distribución, preparación o posesión de una sustancia peligrosa regulada con la intención
de distribuirla dentro de 1.000 pies de distancia de la propiedad de una escuela o colegio (2C:35-7);
distribución, preparación o posesión de una sustancia peligrosa controlada dentro de 500 pies de
distancia de una instalación de viviendas subvencionadas, un parque o edificio público (2C:35-7.1);
o distribución, posesión o fabricación de una imitación de una sustancia peligrosa regulada (2C:3511)
Y
Do you understand that if you plead guilty to any of the following offenses: leader of a narcotics trafficking network
(2C:35-3); operating a controlled dangerous substance production facility (2C:35-4); manufacturing a controlled
dangerous substance (2C:35-5) distribution, possession or manufacture of gamma hydroxybututyrate (2C:35-5.2);
distribution, possession or manufacture of flunitrazepam (2C:35-5.3); employing a juvenile in drug distribution
(2C:35-6); distributing, dispensing or possessing with intent to distribute a controlled dangerous substance within
1,000 feet of school property (2C:35-7); distributing, dispensing or possessing a controlled dangerous substance
within 500 feet of a public housing facility, park or building (2C:35-7.1); or, distribution, possession or manufacture
of an imitation controlled dangerous substance (2C:35-11)
AND
a. también se declara culpable de poseer un arma de
fuego cuando cometió, trató de cometer o conspiró
para cometer cualquiera de esos actos criminales, Ud.
recibirá una sentencia consecutiva por poseer el arma?
[Sí/Yes]
[No/No]
[No aplica/NA]
you also plead guilty to possessing a firearm while
committing, attempting to commit or conspiring to commit
any of these offenses you will receive a consecutive sentence
for possessing the weapon?
O/OR
Formulario enmendado promulgado por la directriz #14-08 (10/08/2008), CN 11169-English-Spanish
Revised Form Promulgated by Directive #14-08 (10/08/2008), CN 11169-English-Spanish
página 1 de 2
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1. b. también se declara culpable de poseer un arma que no
sea de fuego para un propósito ilegal cuando cometió,
trató de cometer o conspiró para cometer cualquiera de
esos actos criminales, recibirá una sentencia
consecutiva por poseer el arma para un propósito
ilegal?
[Sí/Yes]
[No/No]
[No aplica/NA]
[Sí/Yes]
[No/No]
[No aplica/NA]
you also plead guilty to possessing a weapon, other than a
firearm, for an unlawful purpose while committing, ttempting
to commit or conspiring to commit any of these offenses you
will receive a consecutive sentence for possessing the weapon
for an unlawful purpose?
O/OR
c.
también se declara culpable de poseer un arma que no
sea de fuego bajo circunstancias no claramente
apropiadas para el uso legal del arma cuando cometió,
trató de cometer o conspiró para cometer cualquiera de
esos actos criminales, recibirá una sentencia
consecutiva por poseer el arma?
you also plead guilty to possessing a weapon, other than a
firearm, under circumstances not manifestly appropriate for
lawful use of the weapon while committing, attempting to
commit or conspiring to commit any of these offenses you
will receive a consecutive sentence for possessing the
weapon?
Fecha
Date
Acusado
Defendant
Abogado Defensor
Defense Attorney
Fiscal
Prosecutor
Formulario enmendado promulgado por la directriz #14-08 (10/08/2008), CN 11169-English-Spanish
Revised Form Promulgated by Directive #14-08 (10/08/2008), CN 11169-English-Spanish
página 2 de 2
page 2 of 2
ATTACHMENT 9
SUPPLEMENTAL PLEA FORM FOR NO EARLY
RELEASE ACT CASES (for crimes occurring
between June 9, 1997 and June 29, 2001)
ENGLISH AND ENGLISH-SPANISH VERSIONS
New Jersey Judiciary
Supplemental Plea Form for No Early Release Act (NERA) Cases (N.J.S.A. 2C:43-7.2)
The following questions need to be answered only if you are pleading guilty to a first or second degree
violent crime that occurred between June 9, 1997 and June 29, 2001.
A violent crime means any crime in which you caused death, serious bodily injury, or you used or
threatened the immediate use of a deadly weapon. A violent crime also includes any aggravated sexual
assault, or sexual assault in which you used, or threatened the immediate use of, physical force. Deadly
weapon means any firearm or other weapon, device, instrument, material or substance, whether animate
or inanimate, which in the manner in which it is used or intended to be used, is known to be capable of
producing death or serious bodily injury. Serious bodily injury means bodily injury which creates a
substantial risk of death or which causes serious, permanent disfigurement, or protracted loss or
impairment of the function of any bodily member or organ.
1. Do you understand that because of your plea of guilty to
[Yes]
[No]
2. Do you understand that because you have pled guilty to these charges the
court must impose a
year term of parole supervision and that term
will begin as soon as you complete the sentence of incarceration?
First Degree Term of Parole Supervision - 5 years
Second Degree Term ofParole Supervision - 3 years
[Yes]
[No]
3. Do you understand that if you violate the conditions of your parole
supervision that your parole may be revoked and you may be subject to
return to prison to serve all or any portion of the remaining period of
parole supervision, even if you have completed serving the term of
imprisonment previously imposed?
[Yes]
[No]
4. Do you understand that by pleading guilty and admitting that the crime(s)
are a violent crime you are waiving your right to have ajury determine,
beyond a reasonable doubt, that the circurnstance(s) that make the
crime(s) a violent crime(s) are present?
[Yes]
[No]
(List First or Second Degree Violent Crimes)
you will be required to serve 85% of the sentence imposed for that
offense(s) before you will be eligible for parole on that offense(s)?
Date:
Defendant:
Defense Attorney:
Prosecutor:
Revised Form Promulgated by Directive #14-08 (10/8/2008), CN 11170-English
page 1 of 1
Poder Judicial de Nueva Jersey
New Jersey Judiciary
Formulario Suplemental de Declaración en Causes Sujetas a la
Ley Contra Puestas en Libertad Prematuras (NERA) (N.J.S.A. 2C:43-72)
Supplemental Plea Form for No Early Release Act (NERA) Cases (N.J.S.A. 2C:43-7.2)
Es necesario contestar a las siguientes preguntas solamente si usted se está declarando culpable de un
delito violento de primer or segundo grado occurido entre el 9 de junio de 1997 y el 29 de junio de
2001.
The following questions need to be answered only if you are pleading guilty to a first or second degree violent crime that
occurred between June 9, 1997 and June 29, 2001.
Un delito violento significa cualquier delito en que usted causó la muerte, lesiones corporales graves o si
usó o amenazó usar inmediatamente un arma mortífera. Un delito violento tambén incluye cualquier
agresión sexual con agravantes o una agresión sexual en la que usó fisica o amenazó usarla
inmediatamente. Un anna mortífera significan cualquier anna de fuego u otra orma, aparato, instrumento,
material o sustancia, sea animada o inanimada, capaz de producir la muerte o lesiones corporales graves
por la manera en que se usa o en que se tiene la intención de usarla. Lesiones corporales graves
significan lesiones corporales que crean un verdadero riesgo de muerte o que causan una desfiguración
grave y pennaoente o el deterioro o la pérdida prolongada de la fución de cualquier miembro u órgano
del cuerpo.
A violent crime means any crime in which you caused death, serious bodily injury, or you used or threatened the
immediate use of a deadly weapon. A violent crime also includes any aggravated sexual assault, or sexual assault in
which you used, or threatened the immediate use of, physical force. Deadly weapon means any firearm or other weapon,
device, instrument, material or substance, whether animate or inanimate, which in the manner in which it is used or
intended to be used, is known to be capable of producing death or serious bodily injury. Serious bodily injury means
bodily injury which creates a substantial risk of death or which causes serious, permanent disfigurement, or protracted
loss or impairment of the function of any bodily member or organ.
1. ¿Entiende que por su declaración de culpabilidad
[Sí/Yes]
[No/No]
[Sí/Yes]
[No/No]
Do you understand that because of your plea of guilty to
(Indique los deutos violentos de primer o segundo grado)
(List First or Second Degree Violent Crimes)
se requerirá que compla el 85% de la sentencia impuesta por ese delito o
eoos delitos antes que en condiciones de recibir libertad condicional por
ese delito o esos delitos?
you will be required to serve 85% of the sentence imposed for that offense(s)
before you will be eligible for parole on that offense(s)?
2. ¿Entiende que porque se declaró culpable de estes cargos, el juez tiene
que imponer un período de supervisión de la libertad condicional de
años, y que dicho período comenzará en cuanto usted cumpla la sentencia
de encarcelamiento?
Do you understand that because you have pled guilty to these charges the court
year term of parole supervision and that term will begin as
must impose a
soon as you complete the sentence of incarceration?
Período de Supervisión de la Libertad Condicional por un Delito de
Primer Grado - 5 años
First Degree Term of Parole Supervision - 5 years
Período de Supervisión de la Libertad Condicional por un Delito de
Segundo Grado -3 años
Second Degree Term of Parole Supervision - 3 years
Formulario enmendado promulgado por la directriz #14-08 (10/8/2008), CN 11170-English-Spanish
Revised Form Promulgated by Directive #14-08 (10/8/2008), CN 11170-English-Spanish
página 1 de 2
page 1 of 2
3. ¿Entiende que si infringe las condiciones de la supervisión de su libertad
condicional, se podrá revocar su libertad condicional y es posible que
tenga que volver a la cárcel para cumplir todo el período de supervisión
de su libertad condicional o cualquier porción del mismo, aún cuando
usted haya cumplido el período de encarcelamiento que le hubieran
impuesto anterionnente?
[Sí/Yes]
[No/No]
[Sí/Yes]
[No/No]
Do you understand that if you violate the conditions of your parole supervision that
your parole may be revoked and you may be subject to return to prison to serve all
or any portion of the remaining period of parole supervision, even if you have
completed serving the term of imprisonment previously imposed?
4. ¿Entiende que al declararse culpable y admitir que el delito o delitos son
violentos, usted renuncia a su derecho de que un jurado determine, más
allá de una duda razonable, que estén presentes las circunstancias que
hacen que el delito o delitos sean violentos?
Do you understand that by pleading guilty and admitting that the crime(s) are a
violent crime you are waiving your right to have ajury determine, beyond a
reasonable doubt, that the circurnstance(s) that make the crime(s) a violent crime(s)
are present?
Fecha:
Date:
Acusado:
Defendant:
Abogado Defensor:
Defense Attorney:
Fiscal:
Prosecutor:
Formulario enmendado promulgado por la directriz #14-08 (10/8/2008), CN 11170-English-Spanish
Revised Form Promulgated by Directive #14-08 (10/8/2008), CN 11170-English-Spanish
página 2 de 2
page 2 of 2
ATTACHMENT 10
SUPPLEMENTAL PLEA FORM FOR NO EARLY
RELEASE ACT CASES (for crimes occurring on or
after June 29, 2001)
ENGLISH AND ENGLISH-SPANISH VERSIONS
New Jersey Judiciary
Supplemental Plea Form for No Early Release Act (NERA) Cases (N.J.S.A. 2C:43-7.2)
The following questions need to be answered only if you are pleading guilty to one of the following first
or second crimes that occurred on or after June 29, 2001:
murder, aggravated manslaughter or manslaughter, vehicular homicide, aggravated assault, disarming a
law enforcement officer, kidnapping, aggravated sexual assault, sexual assault, robbery, carjacking,
aggravated arson by placing another person in danger of death or serious bodily injury, burglary, theft by
extortion by obtaining property of another by threatening to inflict bodily injury on, or physically
confine or restrain anyone or commit another offense, booby traps in manufacturing or distributing of
CDS facilities or strict liability for drug induced deaths.
1. Do you understand that because of your plea of guilty to
[Yes]
[No]
2. Do you understand that because you have pled guilty to these charges the
court must impose a
year term of parole supervision and that term
will begin as soon as you complete the sentence of incarceration?
First Degree Term of Parole Supervision - 5 years
Second Degree Term of Parole Supervision - 3 years
[Yes]
[No]
3. Do you understand that if you violate the conditions of your parole
supervision that your parole may be revoked and you may be subject to
return to prison to serve all or any portion of the remaining period of
parole supervision, even if you have completed serving the term of
imprisonment previously imposed?
[Yes]
[No]
(List First or Second Degree Violent Crime(s) to Which NERA Applies)
you will be required to serve 85% of the sentence imposed for that
offense(s) before you will be eligible for parole on that offense(s)?
Date:
Defendant:
Defense Attorney:
Prosecutor:
Revised Form Promulgated by Directive #14-08 (10/08/2008), CN 11171-English
page 1 of 1
Poder Judicial de Nueva Jersey
New Jersey Judiciary
Formulario Suplemental de Declaración en Causes Sujetas a la
Ley Contra Puestas en Libertad Prematuras (NERA) (N.J.S.A. 2C:43-72)
Supplemental Plea Form for No Early Release Act (NERA) Cases (N.J.S.A. 2C:43-7.2)
Es necesario contestar a las siguientes preguntas solamente si usted se está declarando culpable de uno
de los siguientes delitos violentos de primer or segundo grado occurido el 29 de junio del 2001 o
después de esa fecha:
The following questions need to be answered only if you are pleading guilty to one of the following first or second
crimes that occurred on or after June 29, 2001:
asesinato, homicidio no premeditado con agravantes u homicidio no premeditado, homicidio cometido
con un vehículo, agresión con agravantes, desannar a un agente del orden publico, rapto, agresión sexual
con agravantes, agresión sexual, robo con violencia, roho de un automóvil con personas adentro,
incendio intencional con agravantes que expone a otra persona al peligro de muerte o lesiones corporales
graves, robo con escalamiento, roho con extorsión at obtener bienes de otra persona con extorsióal
obtener bienes de otra persona amenazándole con infligirle lesiones corporales, o aprisionar o sujetar a
una persona o cometer otro delito, trampas explosivas en instalanciones de fabricación o distribución de
CDS o responsabilidad objetiva por muertes causadas por drogas.
murder, aggravated manslaughter or manslaughter, vehicular homicide, aggravated assault, disarming a law enforcement
officer, kidnapping, aggravated sexual assault, sexual assault, robbery, carjacking, aggravated arson by placing another
person in danger of death or serious bodily injury, burglary, theft by extortion by obtaining property of another by
threatening to inflict bodily injury on, or physically confine or restrain anyone or commit another offense, booby traps in
manufacturing or distributing of CDS facilities or strict liability for drug induced deaths.
1. ¿Entiende que por su declaración de culpabilidad
[Sí/Yes]
[No/No]
[Sí/Yes]
[No/No]
Do you understand that because of your plea of guilty to
Indique los Delitos Violentos de Primer o Segundo Grado Incluídos bajo NERA
(List First or Second Degree Violent Crime(s) to Which NERA Applies)
se requerirá que cumpla el 85% de la sentencia impuesta por ese delito o
esos delitos antes que esté en condiciones de recibir libertad condicional
por ese delito o esos delitos?
you will be required to serve 85% of the sentence imposed for that offense(s)
before you will be eligible for parole on that offense(s)?
2. ¿Entiende que porque se declaró culpable de estos cargos, el juez tiene
que imponer un período de supervisión de la libertad condicional de
años, y que dicho período comenzará en cuanto usted cumpla la sentencia
de encarcelamiento?
Do you understand that because you have pled guilty to these charges the court
year term of parole supervision and that term will begin as
must impose a
soon as you complete the sentence of incarceration?
Período de Supervisión de la Libertad Condicional por un Delito de
Primer Grado - 5 años
First Degree Term of Parole Supervision - 5 years
Período de Supervisión de la Libertad Condicional por un Delito de
se Segundo Grado -3 años
Second Degree Term of Parole Supervision - 3 years
Formulario enmendado promulgado por la directriz #14-08 (10/08/2008), CN 11171-English-Spanish
Revised Form Promulgated by Directive #14-08 (10/08/2008), CN 11171-English-Spanish
página 1 de 2
page 1 of 2
3. ¿Entiende que si infringe las condiciones de la supervisión de su libertad
condicional, se podrá revocar su libertad condicional y es posible que
tenga que volver a la cárcel para cumplir todo el período de supervisión
de su libertad condicional o cualquier porción del mismo, aún cuando
usted haya cumplido el período de encarcelamiento que le hubieran
impuesto anterionnente?
[Sí/Yes]
[No/No]
Do you understand that if you violate the conditions of your parole supervision that
your parole may be revoked and you may be subject to return to prison to serve all
or any portion of the remaining period of parole supervision, even if you have
completed serving the term of imprisonment previously imposed?
Fecha:
Date:
Acusado:
Defendant:
Abogado Defensor:
Defense Attorney:
Fiscal:
Prosecutor:
Formulario enmendado promulgado por la directriz #14-08 (10/08/2008), CN 11171-English-Spanish
Revised Form Promulgated by Directive #14-08 (10/08/2008), CN 11171-English-Spanish
página 2 de 2
page 2 of 2
ATTACHMENT 11
SUPPLEMENTAL PLEA FORM FOR GRAVES ACT
CASES
ENGLISH AND ENGLISH-SPANISH VERSIONS
New Jersey Judiciary
Supplemental Plea Form for Graves Act Offenses (N.J.S.A. 2C: 43-6c)
You are pleading to a Graves Act offense. This means:
A.
You are pleading guilty to possession of a firearm with intent to use it against the person of
another or to murder, aggravated manslaughter, manslaughter, aggravated assault, kidnapping,
aggravated sexual assault, aggravated criminal sexual contact, robbery, burglary or escape;
AND
B.
You are also admitting, by virtue of this plea, that while in the course of committing or
attempting to commit one of the crimes, including the immediate flight therefrom, you used or
were in possession of a firearm.
1. Do you understand that because of your plea of guilty to
[Yes]
[No]
2. Do you understand that by pleading guilty and admitting that you used or
were in possession of a firearm while in the course of committing or
attempting to commit one of the crimes, you are waiving your right to have
a jury determine, beyond a reasonable doubt, that you used or possessed a
firearm during the course of committing or attempting to commit one of the
crimes?
[Yes]
[No]
3. Does any other mandatory sentencing provision apply to the
Graves Act count that provides for a greater period of parole
ineligibility (e.g., NERA, Three Strikes, Murder)?
[No]
[NA]
you will be subject to a minimum period of time before you will be eligible
for parole (a parole ineligibility term) under the Graves Act (as set forth in
question 7 on the three-page plea form)?
[Yes]
If so, which one?
Date
Defendant
Defense Attorney
Prosecutor
Revised Form Promulgated by Directive #14-08 (10/08/2008), CN 11172-English
page 1 of 1
Poder Judicial de Nueva Jersey
New Jersey Judiciary
Formulario de suplemental de declarición para delitos
bajo la ley graves (N.J.S.A. 2C: 43-6c)
Supplemental Plea Form for Graves Act Offenses (N.J.S.A. 2C: 43-6c)
Usted se está declarando culpable de un delito bajo la Ley Graves. Eso significa que:
You are pleading to a Graves Act offense. This means:
A.
Se declara culpable de la posesión de un arma de fuego con la intención de usarla contra otra
persona o de homicidio, homicidio impremeditado con agravantes, homicidio impremeditado,
agresión con agravantes, rapto, agresión sexual con agravantes, contacto sexual criminal con
agravantes, robo, robo con allanamiento de morada o fuga;
You are pleading guilty to possession of a firearm with intent to use it against the person of another or to
murder, aggravated manslaughter, manslaughter, aggravated assault, kidnapping, aggravated sexual assault,
aggravated criminal sexual contact, robbery, burglary or escape;
Y/AND
B.
También admite, en virtud de esta declaración, que cuando cometió o trató de cometer uno de los
delitos, incluyendo su fuga inmediata, usted usó un arma de fuego o tenía una en su posesión.
You are also admitting, by virtue of this plea, that while in the course of committing or attempting to commit
one of the crimes, including the immediate flight therefrom, you used or were in possession of a firearm.
1. ¿Entiende que por su declaración de culpabilidad de
[Sí/Yes]
[No/No]
[Sí/Yes]
[No/No]
Do you understand that because of your plea of guilty to
estará sujeto a un período mínimo antes de estar en condiciones de salir en
libertad condicional (un período en que no está en en condiciones de salir en
libertad condicional) bajo la Ley Graves (según se expone en la pregunta 7
del formulario de declaración de tres páginas)?
you will be subject to a minimum period of time before you will be eligible for parole
(a parole ineligibility term) under the Graves Act (as set forth in question 7 on the
three-page plea form)?
2. ¿Entiende que al declararse culpable y admitir que usó un arma de fuego o
tenía una en su posesión cuando cometió o trató de cometer uno de los
delitos, usted renuncia al derecho de que un jurado determine, más allá de
una duda razonable, que usó o poseía un arma de cuando cometió o trató de
cometer uno de los delitos?
Do you understand that by pleading guilty and admitting that you used or were in
possession of a firearm while in the course of committing or attempting to commit one
of the crimes, you are waiving your right to have a jury determine, beyond a reasonable
doubt, that you used or possessed a firearm during the course of committing or
attempting to commit one of the crimes?
Formulario enmendado promulgado por la directriz #14-08 (10/08/2008), CN 11172-English-Spanish
Revised Form Promulgated by Directive #14-08 (10/08/2008), CN 11172-English-Spanish
página 1 de 2
page 1 of 2
3. ¿Corresponde al cargo de la Ley Graves alguna otra
disposición obligatoria de sentencia que estipule un
período más largo en que no se pueda salir en libertad
condicional (e.g., NERA, Tercera vez, Homicidio)?
[Sí/Yes]
[No/No]
[No Me Incumbe/NA]
Does any other mandatory sentencing provision apply to the
Graves Act count that provides for a greater period of parole
ineligibility (e.g., NERA, Three Strikes, Murder)?
Si corresponde alguna, ¿cuál es?
If so, which one?
Fecha
Date
Acusado:
Defendant
Abagado Defensor:
Defense Attorney
Fiscal:
Prosecutor
Formulario enmendado promulgado por la directriz #14-08 (10/08/2008), CN 11172-English-Spanish
Revised Form Promulgated by Directive #14-08 (10/08/2008), CN 11172-English-Spanish
página 2 de 2
page 2 of 2
ATTACHMENT 12
FOUR - PAGE JUDGMENT OF CONVICTION
Superior Court of New Jersey,
State of New Jersey
v.
Last Name
First Name
Middle Name
Also Known As
Date of Birth
SBI Number
Date of Arrest
Date(s) of Offense
Original Plea
Date Ind / Acc / Complt Filed
PROMIS Number
Not Guilty
Adjudication By
Guilty Plea
Jury Trial Verdict
Non-Jury Trial Verdict
Date of Original Plea
Guilty
Dismissed / Acquitted
Date:
Original Charges
Ind / Acc / Complt
Count
Description
Statute
Degree
Count
Description
Statute
Degree
Final Charges
Ind / Acc / Complt
Sentencing Statement
It is, therefore, on
ORDERED and ADJUDGED that the defendant is sentenced as follows:
It is further ORDERED that the sheriff deliver the defendant to the appropriate correctional authority.
Total Custodial Term
Institution Name
New Jersey Judiciary, Revised Form Promulgated by Directive #14-08 (10/08/2008), CN: 10070-English
Copies to: County Probation Division
Defendant
Defense Counsel
Prosecutor
Total Probation Term
State Parole Board
page 1 of 4
Dept of Corrections or County Penal Institution
State of New Jersey v.
,
S.B.I. #
DEDR (N.J.S.A. 2C:35-15 and 2C:35-5.11)
Ind / Acc / Complt #
Additional Conditions
A mandatory Drug Enforcement and Demand Reduction (DEDR)
penalty is imposed for each count. (Write in number of counts for
each degree.)
The defendant is hereby ordered to provide a DNA sample and
ordered to pay the costs for testing of the sample provided
(N.J.S.A. 53:1-20.20).
DEDR penalty reduction granted (N.J.S.A. 2C:35-15a(2))
Standard
@
@
@
@
1st Degree
2nd Degree
3rd Degree
4th Degree
DP or
Petty DP
The defendant is hereby sentenced to community supervision for
life. (If offense occurred before 1/14/04) (N.J.S.A. 2C:43-6.4)
Doubled
@
@
@
@
$
$
$
$
@ $
$
$
$
$
The defendant is hereby sentenced to parole supervision for life.
(If offense occurred on or after 1/14/04) (N.J.S.A. 2C:43-6.4).
year term of
The defendant is hereby ordered to serve a
parole supervision, which term shall begin as soon as defendant
completes the sentence of incarceration. (N.J.S.A. 2C:43-7.2).
@ $
Total DEDR Penalty $
The court further ORDERS that collection of the DEDR penalty be
suspended upon defendant's entry into a residential drug program
for the term of the program. (N.J.S.A. 2C:35-15e)
The court imposes a restraining order pursuant to DORA. (N.J.S.A.
2C:35-5.7(h)). Restraining Order expires
Findings Per N.J.S.A. 2C:47-3
Total Lab Fee
Forensic Laboratory Fee (N.J.S.A. 2C:35-20)
Offenses @ $
The court finds that the defendant's conduct was characterized
by a pattern of repetitive and compulsive behavior.
$
VCCA Assessment (N.J.S.A. 2C:43-3.1)
Counts
Number
The court finds that the defendant is amenable to sex offender
treatment.
Amount
@
$
@
$
@
$
@
$
The court finds that the defendant is willing to participate in sex
offender treatment.
License Suspension
Waived
CDS / Paraphernalia (N.J.S.A. 2C:35-16)
Total VCCA Assessment $
Auto Theft / Unlawful Taking (N.J.S.A. 2C:20-2.1)
Vehicle Theft / Unlawful Taking Penalty
(N.J.S.A. 2C:20-2.1)
Eluding (N.J.S.A. 2C:29-2)
Mandatory Penalty
Offense
$
Other Fees and Penalties
Law Enforcement Officers Training
and Equipment Fund Penalty
(N.J.S.A. 2C:43-3.3)
Number of Months
Offenses @ $
Total: $
$
Non-resident driving privileges revoked
Safe Neighborhood Services Fund
Assessment (N.J.S.A. 2C:43-3.2)
$
Probation Supervision Fee
(N.J.S.A. 2C:45-1d)
Other
End Date
Start Date
Details
Statewide Sexual Assault Nurse
Examiner Program Penalty
(N.J.S.A. 2C:43-3.6)
Offenses @ $
Jurisdiction
Driver's License Number
Total $
Probation Transaction Fee
(N.J.S.A. 2C:46-1d(1))
If the court is unable to collect the license, complete the following:
Certain Sexual Offenders Surcharge Defendant's Address
(N.J.S.A. 2C:43-3.7)
$
$
Domestic Violence Offender
Surcharge (N.J.S.A. 2C:25-29.4)
Sex Crime Victim Treatment Fund
Penalty (N.J.S.A. 2C:14-10)
$
City
State
Zip
$
Total Fine(s)
Total Restitution
Total Financial Obligation Date of Birth
$
$
$
Sex
Eye Color
M
F
Details
New Jersey Judiciary, Revised Form Promulgated by Directive #14-08 (10/08/2008), CN: 10070-English
Copies to: County Probation Division
Defendant
Defense Counsel
Prosecutor
State Parole Board
page 2 of 4
Dept of Corrections or County Penal Institution
State of New Jersey v.
,
S.B.I. #
Ind / Acc / Complt #
Time Credits
Time Spent in Custody
R. 3:21-8
- To
Total Number of Days
Date: From
Gap Time Spent in Custody
N.J.S.A. 2C:44-5b(2)
Prior Service Credit
- To
Total Number of Days
- To
Total Number of Days
Date: From
Date: From
Rosado Time
- To
Total Number of Days
Date: From
Statement of Reasons - Include all applicable aggravating and mitigating factors
Form Prepared By
Last Name
First Name
Attorney for Defendant at Sentencing
Last Name
First Name
Middle Initial
Prosecutor at Sentencing
Last Name
First Name
Middle Initial
Judge at Sentencing
Last Name
Preparer Telephone Number
Public Defender
Yes
No
Deputy Attorney General
Yes
First Name
Judge (Signature)
New Jersey Judiciary, Revised Form Promulgated by Directive #14-08 (10/08/2008), CN: 10070-English
Copies to: County Probation Division
Defendant
Defense Counsel
Prosecutor
No
Middle Initial
Date
State Parole Board
page 3 of 4
Dept of Corrections or County Penal Institution
State of New Jersey v.
,
S.B.I. #
Ind / Acc / Complt #
Continuation
New Jersey Judiciary, Revised Form Promulgated by Directive #14-08 (10/08/2008), CN: 10070-English
Copies to: County Probation Division
Defendant
Defense Counsel
Prosecutor
State Parole Board
page 4 of 4
Dept of Corrections or County Penal Institution

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